MEDICARE: SUSAN CAROLINE ROSS PROVISIONAL LPC.

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
1	101YP2500X	Professional Counselor	05262-P	KS

General Provider Information

NPI Number	:	1952252421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CAROLINE ROSS PROVISIONAL LPC.

Provider Business Mailing Address
First Line	:	2333 SE OAKWOOD DR
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66605-3515
Country	:	US
Telephone Number	:	785-220-0787
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 SW URISH RD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66615-1248
Country	:	US
Telephone Number	:	785-267-5900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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