Provider Demographics
NPI:1497966550
Name:PATRICIA DELL-ROSS, INC.
Entity Type:Organization
Organization Name:PATRICIA DELL-ROSS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:DELL-ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:978-618-7994
Mailing Address - Street 1:42 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2606
Mailing Address - Country:US
Mailing Address - Phone:978-618-7994
Mailing Address - Fax:978-462-7333
Practice Address - Street 1:42 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2606
Practice Address - Country:US
Practice Address - Phone:978-618-7994
Practice Address - Fax:978-462-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA01046531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA052384020OtherMAGELLAN ID #
MA004112OtherVALUE OPTIONS INDIV ID #
MA1404200YOMA01OtherANTHEM BCBS
MA4212987OtherAETNA ID NUMBER
MAP10260OtherBCBS MA GROUP ID NUMBER
MAP50031OtherBCBS INDIV ID #
MA684200OtherBEACON HS
MA1014950OtherFALLON ID #
MAA021518OtherVALUE OPTIONS ID NUMBER
MA1039062OtherCIGNA ID NUMBER
MA4212987OtherAETNA ID NUMBER
MAP21992Medicare UPIN
MA1039062OtherCIGNA ID NUMBER