Provider Demographics
NPI:1801347232
Name:ROSS, JAMES SR (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ROSS
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 CRESWELL AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3918
Mailing Address - Country:US
Mailing Address - Phone:318-458-5235
Mailing Address - Fax:318-990-5599
Practice Address - Street 1:510 E STONER AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4243
Practice Address - Country:US
Practice Address - Phone:318-458-5235
Practice Address - Fax:318-990-5599
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA98451041C0700X
LA98541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical