Provider Demographics
NPI:1548288038
Name:ROSS, JANE D (LPC)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:D
Last Name:ROSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARILYN JANE
Other - Middle Name:DICKERSON
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCP
Mailing Address - Street 1:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81402
Mailing Address - Country:US
Mailing Address - Phone:970-249-9694
Mailing Address - Fax:970-249-2955
Practice Address - Street 1:605 E MIAMI ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-249-9694
Practice Address - Fax:970-249-2955
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional