Provider Demographics
NPI:1063652048
Name:ROSS, LOIS KRIEGER (LMSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:KRIEGER
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-5126
Mailing Address - Country:US
Mailing Address - Phone:518-281-5142
Mailing Address - Fax:
Practice Address - Street 1:435 FOURTH STREET
Practice Address - Street 2:UNITY SUNSHINE
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180
Practice Address - Country:US
Practice Address - Phone:518-274-3234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033548-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker