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NPI Code Detail

MEDICARE: TAWANNA D ROSS LPC

MEDICARE: TAWANNA D ROSS LPC
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
1101Y00000XCounselor6451017686MI
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1538552633
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAWANNA D ROSS LPC
Provider Business Mailing Address
First Line : 51074 MOTT RD TRLR 28
Second Line :
City : CANTON
State : MI
Zip : 48188-2139
Country : US
Telephone Number : 734-725-1143
Fax Number :
Provider Business Practice Location Address
First Line : 5958 N CANTON CENTER RD STE 900
Second Line :
City : CANTON
State : MI
Zip : 48187-2740
Country : US
Telephone Number : 734-737-1200
Fax Number : 734-737-1205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2015
Last Update Date : 06/19/2025

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Directions to “ TAWANNA D ROSS LPC” Practice Location

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