Healthcare Provider Details

I. General information

NPI: 1033683248
Provider Name (Legal Business Name): TASHA N ROSS MSW, CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 08/02/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GREENUP ST
COVINGTON KY
41011-2524
US

IV. Provider business mailing address

1700 LONDON ACRES DR
NEWPORT KY
41071-2626
US

V. Phone/Fax

Practice location:
  • Phone: 859-349-0700
  • Fax:
Mailing address:
  • Phone: 859-907-0533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number258240
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: