Provider Demographics
NPI:1679185607
Name:ROSS COUNSELING LLC
Entity Type:Organization
Organization Name:ROSS COUNSELING LLC
Other - Org Name:ROSS COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIZZY
Authorized Official - Middle Name:DIANNA
Authorized Official - Last Name:PITTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-868-7762
Mailing Address - Street 1:1120 MIDDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2408
Mailing Address - Country:US
Mailing Address - Phone:443-868-7762
Mailing Address - Fax:443-868-7643
Practice Address - Street 1:1120 MIDDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-2408
Practice Address - Country:US
Practice Address - Phone:443-868-7762
Practice Address - Fax:443-868-7643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD589561800Medicaid
MD101YM0800XMedicaid