Individual
ANDREW ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 18TH ST, ROCK ISLAND, IL 61201-8715
(309) 788-6374
Mailing address
303 18TH ST, ROCK ISLAND, IL 61201-8715
(309) 778-6374
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180010880
IL
101YP2500X
Professional Counselor
Primary
180010880
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180010880
ILLINOIS LCPC
IL
Enumeration date
06/22/2017
Last updated
11/10/2017
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