Individual
AUSTIN M ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA.172160
Contact information
Practice address
323 MARION PIKE STE 3, COAL GROVE, OH 45638
(740) 646-6640
(866) 475-7263
Mailing address
323 MARION PIKE STE 3, COAL GROVE, OH 45638-2958
(740) 646-6640
(866) 475-7263
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.168269
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.172160
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324260
—
OH
Enumeration date
11/06/2018
Last updated
06/01/2020
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