Individual
MS. CANDACE A ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, MAC, CCTP
Contact information
Practice address
1107 REAM AVE, MOUNT SHASTA, CA 96067-9768
(530) 918-7200
Mailing address
238 S PENNSYLVANIA AVE UNIT 671, GREENSBURG, PA 15601-3659
(412) 646-6263
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CW012500
PA
1041C0700X
Clinical Social Worker
Primary
CW012500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0548084
—
PA
01
—
173873
BLUE CROSS PROVIDER NUMBE
PA
Enumeration date
10/05/2006
Last updated
04/16/2024
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