MRS. SHASTA LANE GROSS (MA, LPC) – Professional Counselor, NPI 1184143539

MRS. SHASTA LANE GROSS (MA, LPC) is a healthcare provider. based in Grand rapids, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LPC. They hold a License No. 6401018315 (MI). The NPI Number for MRS. SHASTA LANE GROSS (MA, LPC) is 1184143539

Main info

Female
15 Years Of Experience
Name
MRS. SHASTA LANE GROSS (MA, LPC)
NPI
1184143539
Phone
(616) 942-7294
Address
3300 36TH ST SE
Enumeration Date
18 September 2017
Last Update Date
4 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6168161758
Graduation Year
2011 (15 years ago)
PAC ID
6305295940
Group Practice PAC ID
1557730603
Professional Enrollment ID
I20231208000266
Address ID
MI495462426GR2305XSEXX502
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

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Provider Addresses for MRS. SHASTA LANE GROSS (MA, LPC)

  • 36th Street Southeast, Cedar Rapids, Linn County, Iowa, 52403, United States

    GRAND RAPIDS, MI 495122810

    Phone: (616) 942-7294

    Fax: (616) 942-0589

    Type: Mailing

  • 2305 E PARIS AVE SE STE 203

    GRAND RAPIDS, MI 495462426

    Phone: (616) 816-1758

    Fax: (616) 333-7685

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231208000266IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49512)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557730603View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical PsychologistMI

Reviews

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Frequently asked questions

How do payers reference MRS. SHASTA LANE GROSS (MA, LPC)?
For MRS. SHASTA LANE GROSS (MA, LPC), use NPI 1184143539 as the unique 10-digit identifier.
Would MRS. SHASTA LANE GROSS (MA, LPC) appear as active to a payer?
You can treat MRS. SHASTA LANE GROSS (MA, LPC) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for MRS. SHASTA LANE GROSS (MA, LPC)?
At a glance, MRS. SHASTA LANE GROSS (MA, LPC) is tied to Professional Counselor. Clinical services aligned with this taxonomy classification.
Is MRS. SHASTA LANE GROSS (MA, LPC) associated with Grand Rapids?
Public fields place MRS. SHASTA LANE GROSS (MA, LPC) around Grand Rapids, Michigan. Always confirm the exact site before visiting.
Can I trust this NPI listing for MRS. SHASTA LANE GROSS (MA, LPC)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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