Provider Demographics
NPI:1114049137
Name:ROSS, ROSANN MARY (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ROSANN
Middle Name:MARY
Last Name:ROSS
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 W 20TH ST
Mailing Address - Street 2:BLDG. M-2
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4625
Mailing Address - Country:US
Mailing Address - Phone:970-336-1123
Mailing Address - Fax:
Practice Address - Street 1:7251 W 20TH ST
Practice Address - Street 2:BLDG. M-2
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4625
Practice Address - Country:US
Practice Address - Phone:970-336-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1436101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health