Individual
MR. ROSS G PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
6980 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-3900
(414) 773-4312
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 773-4312
(414) 454-6450
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6652
WI
1041C0700X
Clinical Social Worker
Primary
6652
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100014396
—
WI
Enumeration date
07/25/2006
Last updated
10/03/2023
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