Provider Demographics
NPI:1821505116
Name:ROSS, ELLEN ABRA (LMHC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:ABRA
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:ROSS
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 17188
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98127-0888
Mailing Address - Country:US
Mailing Address - Phone:206-356-0803
Mailing Address - Fax:844-913-1911
Practice Address - Street 1:7326 13TH AVE NW APT 3
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5374
Practice Address - Country:US
Practice Address - Phone:206-356-0803
Practice Address - Fax:844-913-1911
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61185771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health