Provider Demographics
NPI:1932262664
Name:ROSS, CATHERINE B (MAMHC & LADC I)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:B
Last Name:ROSS
Suffix:
Gender:F
Credentials:MAMHC & LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MILLYARD UNIT 306
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2441
Mailing Address - Country:US
Mailing Address - Phone:978-388-9948
Mailing Address - Fax:
Practice Address - Street 1:60 GRANITE ST
Practice Address - Street 2:BAYRIDGE HOSPITAL
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-2915
Practice Address - Country:US
Practice Address - Phone:781-599-9200
Practice Address - Fax:781-477-6949
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1656LADC I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)