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General NPI Number Information
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NPI Number | 1306302799
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Entity Type | Individual
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Provider Name | KRISTAN A ROSS MS, LCAS-A
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Gender | Female
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1895 E DIXON BLVD
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City | SHELBY
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State | NC
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Zip | 28152-6901
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Country | US
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Telephone | 980-306-4201
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Fax | 704-445-7016
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Provider Business Mailing Address
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Address Line | 504 JC DELLINGER RD
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City | CHERRYVILLE
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State | NC
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Zip | 28021-8916
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Country | US
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Telephone | 980-269-3106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-29980
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License Number State | NC
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