Provider Demographics
NPI:1376000679
Name:ROSS, MONICA DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:DAWN
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:P.O. BOX 86
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631
Mailing Address - Country:US
Mailing Address - Phone:256-606-1610
Mailing Address - Fax:
Practice Address - Street 1:106 LEE ST. NE, SUITE C
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-340-0300
Practice Address - Fax:256-340-0353
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4027101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor