Provider Demographics
NPI:1922887934
Name:ROSS, COLLIN ROSS
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:ROSS
Last Name:ROSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2589 NAYLOR RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4031
Mailing Address - Country:US
Mailing Address - Phone:202-527-4605
Mailing Address - Fax:
Practice Address - Street 1:2589 NAYLOR RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4031
Practice Address - Country:US
Practice Address - Phone:202-527-4605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)