Provider Demographics
NPI:1295949899
Name:ROSS, RICHARD (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 N FRANKLIN TPKE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1602
Mailing Address - Country:US
Mailing Address - Phone:201-828-9456
Mailing Address - Fax:201-828-5850
Practice Address - Street 1:145 N FRANKLIN TPKE
Practice Address - Street 2:SUITE 330
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1602
Practice Address - Country:US
Practice Address - Phone:201-828-9456
Practice Address - Fax:201-828-5850
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053759001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical