Provider Demographics
NPI:1669532958
Name:ROSS, DEBORAH (LPC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8233 OLD COURTHOUSE RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3816
Mailing Address - Country:US
Mailing Address - Phone:571-282-3511
Mailing Address - Fax:
Practice Address - Street 1:8233 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE 340
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3816
Practice Address - Country:US
Practice Address - Phone:571-282-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional