Healthcare Provider Details

I. General information

NPI: 1881521565
Provider Name (Legal Business Name): JENNA LYNN ROSS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 W THUNDERBIRD RD STE E454
GLENDALE AZ
85306-4646
US

IV. Provider business mailing address

2850 N COUNTRY CLUB RD
TUCSON AZ
85716-1910
US

V. Phone/Fax

Practice location:
  • Phone: 480-870-3010
  • Fax: 480-716-6990
Mailing address:
  • Phone: 520-322-6274
  • Fax: 520-509-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number24764
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: