Kellie Michelle Ross, LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCAS-21914 Issued in NC

Practice address

439 Ramsey St
Fayetteville, NC 28301-4909

Phone

(919) 787-6131

NPI assigned

Nov 30, 2015

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1316268345

  Addiction (Substance Use Disorder)

  NPD
• Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1932300019
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1417321563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014909",
            "telephone_number": "919-787-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KELLIE",
        "middle_name": "MICHELLE",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-30",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21914",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LCAS-21914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda K Ross, LCSWA
• Charles J Ross, IDMT
• Jerlinda Gladys Camille Ross, M.D.
• Karen Ross
• Karlishia Shenay Ross
• Melissa Marlene Ross, M.ED, CF- SLP
• Micaela Ross
• Shenita Melvin Ross, DHA, MSW, LCSWA
• Stacey Ross, RN
• Mender L Roston

• Addiction (Substance Use Disorder) Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.