Provider Demographics
NPI:1154309508
Name:ROSS, FAYE (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:FAYE
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7124 MIAMI AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2675
Mailing Address - Country:US
Mailing Address - Phone:513-272-0066
Mailing Address - Fax:513-272-0127
Practice Address - Street 1:7124 MIAMI AVE
Practice Address - Street 2:SUITE D
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2675
Practice Address - Country:US
Practice Address - Phone:513-272-0066
Practice Address - Fax:513-272-0127
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.4501-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRO21865Medicare ID - Type Unspecified