Individual
KELLIE MICHELLE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
439 RAMSEY ST, FAYETTEVILLE, NC 28301-4909
(919) 787-6131
Mailing address
3125 POPLARWOOD CT STE 203, RALEIGH, NC 27604-6445
(919) 787-6131
(919) 571-2932
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-21914
NC
101YM0800X
Mental Health Counselor
LCAS-21914
NC
Other
Enumeration date
11/30/2015
Last updated
03/05/2025
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