MRS. SHASTA LANE GROSS MA, LPC
NPI 1184143539
Counselor - Professional in Grand Rapids, MI

Q: What is Shasta Gross's NPI number?

The NPI number for Shasta Gross is 1184143539. It was assigned to this individual provider in the NPPES registry on September 18, 2017.

Q: What is Shasta Gross's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Shasta Gross was last updated on December 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 18, 2017PECOS Enrolled

2305 E PARIS AVE SE STE 203, GRAND RAPIDS, MI 49546(616) 816-1758(616) 333-7685 Get Directions Write a Review

NPPES record last updated: December 4, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2023, Jun 22, 2020, Mar 11, 2019 and 1 more (4 updates tracked since 2017).

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About Mrs. Shasta Lane Gross Ma, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SHASTA LANE GROSS MA, LPC (NPI 1184143539) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401018315) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1184143539

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMRS. SHASTA LANE GROSSCredential: MA, LPC

Location Address2305 E PARIS AVE SE STE 203Grand Rapids, MI 49546-2426

Mailing Address2305 E Paris Ave Se Ste 203Grand Rapids, MI 49546-2426 · (616) 816-1758 · Fax (616) 333-7685

Phone(616) 816-1758

Fax(616) 333-7685

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateSeptember 18, 2017

Last NPPES UpdateDecember 4, 20234 updates tracked since enumeration

NPPES CertifiedDecember 4, 2023

✔ NPI 1184143539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MI · 6401018315

2305 E PARIS AVE SE STE 203, Grand Rapids, MI 49546

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shasta Lane Gross Ma, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305295940

PECOS Enrollment IDI20231208000266

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRYAN ROSS CREEGER

Counselor (Mental Health)