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NPI Code Detail

MEDICARE: ALYSIA S ROSS MS, LMHC, MAC, DVC

MEDICARE: ALYSIA S ROSS MS, LMHC, MAC, DVC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH9547FL

General Provider Information

NPI Number : 1942458856
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSIA S ROSS MS, LMHC, MAC, DVC
Provider Business Mailing Address
First Line : 1661 EAST BAY DRIVE
Second Line :
City : LARGO
State : FL
Zip : 33771-2207
Country : US
Telephone Number : 727-582-8000
Fax Number : 727-587-7924
Provider Business Practice Location Address
First Line : 1661 EAST BAY DRIVE
Second Line :
City : LARGO
State : FL
Zip : 33771-2207
Country : US
Telephone Number : 727-582-8000
Fax Number : 727-587-7924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2008
Last Update Date : 09/04/2008

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