Provider Demographics
NPI:1518994219
Name:ROSS, GENE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GENE
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WELLINGTON OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-5571
Mailing Address - Country:US
Mailing Address - Phone:940-566-3416
Mailing Address - Fax:
Practice Address - Street 1:13 WELLINGTON OAKS CIR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-5571
Practice Address - Country:US
Practice Address - Phone:940-566-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical