MEDICARE: MRS. ERICA OWEN ROSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	3185	TN

General Provider Information

NPI Number	:	1538335096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA OWEN ROSS

Provider Business Mailing Address
First Line	:	790 NEW VALLEY RD
Second Line	:
City	:	GLEASON
State	:	TN
Zip	:	38229-6900
Country	:	US
Telephone Number	:	731-514-5268
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 MEMORIAL DR
Second Line	:
City	:	PARIS
State	:	TN
Zip	:	38242-5413
Country	:	US
Telephone Number	:	731-641-4141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	12/18/2025

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