Healthcare Provider Details

I. General information

NPI: 1245173152
Provider Name (Legal Business Name): DARREN ROSS JR. LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N DUNDALK AVE
BALTIMORE MD
21222-4221
US

IV. Provider business mailing address

3049 MAYFIELD AVE
BALTIMORE MD
21213-1740
US

V. Phone/Fax

Practice location:
  • Phone: 667-600-3680
  • Fax:
Mailing address:
  • Phone: 443-864-8394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33537
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: