Provider Demographics
NPI:1548494982
Name:ROSS, CAROL JEAN (LPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
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 1:2292 W MAGEE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-4301
Mailing Address - Country:US
Mailing Address - Phone:520-405-1471
Mailing Address - Fax:520-544-8312
Practice Address - Street 1:2292 W MAGEE RD
Practice Address - Street 2:SUITE 260
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-4301
Practice Address - Country:US
Practice Address - Phone:520-405-1471
Practice Address - Fax:520-544-8312
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12043101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor