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General NPI Number Information
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NPI Number | 1235648668
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Entity Type | Organization
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Legal Business Name | JULIE ROSS, LCSW, LMHP, LLC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 11/07/2017
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Provider Practice Location Address
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Address Line | 1627 E MILITARY AVE STE 200
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City | FREMONT
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State | NE
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Zip | 68025-5490
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Country | US
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Telephone | 402-727-4886
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Fax | 402-727-4146
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Provider Business Mailing Address
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Address Line | 1738 PARKVIEW DR
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City | FREMONT
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State | NE
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Zip | 68025-4484
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Country | US
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Telephone | 402-727-1681
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | JULIE DIANE ROSS
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Credential | LCSW, LMHP
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Telephone | 402-727-1681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 918
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 918
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License Number State | NE
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