Provider Demographics
NPI:1427945823
Name:ROSS, ALISSA JANE (LPC-IT)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:JANE
Last Name:ROSS
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8651 N PORT WASHINGTON RD STE C
Mailing Address - Street 2:
Mailing Address - City:FOX POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2203
Mailing Address - Country:US
Mailing Address - Phone:262-251-1112
Mailing Address - Fax:
Practice Address - Street 1:8651 N PORT WASHINGTON RD STE C
Practice Address - Street 2:
Practice Address - City:FOX POINT
Practice Address - State:WI
Practice Address - Zip Code:53217-2203
Practice Address - Country:US
Practice Address - Phone:262-251-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8266226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health