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General NPI Number Information
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NPI Number | 1336648203
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Entity Type | Individual
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Provider Name | TENISHA ROSS LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 216 W DIXON BLVD STE A-1
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City | SHELBY
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State | NC
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Zip | 28152-6500
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Country | US
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Telephone | 704-476-9016
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Fax |
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Provider Business Mailing Address
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Address Line | 848 OLD BOILING SPRINGS RD
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City | SHELBY
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State | NC
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Zip | 28152-0519
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Country | US
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Telephone | 704-284-1257
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P011907
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C012516
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License Number State | NC
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