Individual
JEREMY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CSAC
Contact information
Practice address
58 BEACH RD, HAMPTON, VA 23664-1834
(757) 778-7470
Mailing address
58 BEACH RD, HAMPTON, VA 23664-1834
(757) 778-7470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102912
VA
101YP2500X
Professional Counselor
Primary
0701006303
VA
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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