Provider Demographics
NPI:1114267267
Name:ROSS, JEANNE O (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:O
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 ALCOVA DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-2116
Mailing Address - Country:US
Mailing Address - Phone:410-507-2389
Mailing Address - Fax:410-507-2389
Practice Address - Street 1:134 HOLIDAY CT
Practice Address - Street 2:SUITE 302
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7008
Practice Address - Country:US
Practice Address - Phone:410-266-1600
Practice Address - Fax:410-266-5554
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical