Provider Demographics
NPI:1598829780
Name:ROSS, PARBATIE (LCSW)
Entity Type:Individual
Prefix:
First Name:PARBATIE
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MALLA
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:4113 LAKE LYNN DR
Mailing Address - Street 2:APT. 102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3447
Mailing Address - Country:US
Mailing Address - Phone:919-900-8191
Mailing Address - Fax:
Practice Address - Street 1:4113 LAKE LYNN DR
Practice Address - Street 2:102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-3447
Practice Address - Country:US
Practice Address - Phone:919-900-8191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0069671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical