Basic Information
| Provider Information | |||||||||
| NPI: | 1871901595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSS | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | ALLEN | ||||||||
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| Credential: | LCMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 CHARLOTTE HWY STE E | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288038681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287769777 | ||||||||
| FaxNumber: | 8286319280 | ||||||||
| Practice Location | |||||||||
| Address1: | 204 CHARLOTTE HWY STE E | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288038681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283335708 | ||||||||
| FaxNumber: | 8284841025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2014 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 14014 | NC | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 14014 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.