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Individual

BILLY ROGERS ROSS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
215 WILDWOOD AVE, LEBANON, TN 37087-3439
(615) 489-5047
Mailing address
14 PRITCHETT LN E, BRUSH CREEK, TN 38547-2027
(615) 489-5047

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
613
TN
101YP2500X
Professional Counselor
Primary
613
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
42-156-1155
EMPLOYEE ID NUMBER
TN
Enumeration date
03/25/2007
Last updated
10/23/2017
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