Provider Demographics
NPI:1326657941
Name:ROSS, ALEXANDRA EVE HAMLET (MA, LPC, SAC, NCC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:EVE HAMLET
Last Name:ROSS
Suffix:
Gender:F
Credentials:MA, LPC, SAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2225
Mailing Address - Country:US
Mailing Address - Phone:908-376-9163
Mailing Address - Fax:
Practice Address - Street 1:55 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2225
Practice Address - Country:US
Practice Address - Phone:908-376-9163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00724200101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional