Provider Demographics
NPI:1265836902
Name:ROSS, SHEIKETHA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHEIKETHA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HAZEL TERRACE
Mailing Address - Street 2:SUITE 23
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-5991
Mailing Address - Country:US
Mailing Address - Phone:203-819-7650
Mailing Address - Fax:203-298-9487
Practice Address - Street 1:54 E RAMSDELL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1140
Practice Address - Country:US
Practice Address - Phone:203-781-4600
Practice Address - Fax:203-781-4624
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008056047OtherROSS MEDICAID
CT008042339Medicaid
CT008056047OtherROSS MEDICAID
CT008024427Medicaid