Provider Demographics
NPI:1013782283
Name:ROSS, DAVID (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 RHODE ISLAND AVE NE APT 157
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1478
Mailing Address - Country:US
Mailing Address - Phone:561-339-3390
Mailing Address - Fax:
Practice Address - Street 1:680 RHODE ISLAND AVE NE APT 157
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1478
Practice Address - Country:US
Practice Address - Phone:561-339-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000029101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical