Individual
HALEY SHAE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
20 WEST 18TH STREET, COVINGTON, KY 41011-3329
(859) 757-0717
(859) 331-2425
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 757-0717
(859) 331-2425
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
252654
KY
104100000X
Social Worker
Primary
254621
KY
1041C0700X
Clinical Social Worker
254621
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
07/31/2017
Last updated
11/08/2023
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