Active NPI
Kathleen M Ross, LPC
- Professional Counselor
- Green Bay, WI
National Provider Identifier
1235325309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3898-125
- Practice address
- 300 Crooks St
Green Bay, WI 54301-4527 - Phone
- (920) 436-4360
- NPI assigned
- Sep 21, 2007
- Last updated
- Feb 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3898-125 | WI | Primary |
Addresses
Primary practice location
300 Crooks St
Green Bay, WI 54301-4527
Mailing address
300 Crooks St
Green Bay, WI 54301-4527
Phone (920) 436-4360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43724700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3898-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233619200000",
"number": "1235325309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 CROOKS ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543014527",
"telephone_number": "920-436-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 CROOKS ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543014527",
"telephone_number": "920-436-4360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "KATHLEEN",
"middle_name": "M",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-21",
"last_updated": "2009-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3898-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43724700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.