Provider Demographics
NPI:1952992851
Name:ROSS, CHESTER DAVON (MS)
Entity Type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:DAVON
Last Name:ROSS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SE 13TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-8617
Mailing Address - Country:US
Mailing Address - Phone:352-256-5662
Mailing Address - Fax:
Practice Address - Street 1:226 NE SANCHEZ AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5871
Practice Address - Country:US
Practice Address - Phone:352-843-2168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health