Doctor Name: | MR. JOHNNIE ROSS |
NPI Number: | 1003921164 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W. |
License Number: | 1693-M |
Business Practice Address: | 2200 Fort Roots Dr North Little Rock, AR - 721141709 |
Business Phone Number: | 5012573123 |
Business Fax Number: | |
Mailing Address: | 2200 Fort Roots Dr, NORTH LITTLE ROCK |
State: | AR |
Postal Code: | 721141709 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/20/2006 |
NPI Last Update Date: | 11/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1693-M |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |