Iman J. Ross, PHD, LPC, P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18030 Issued in TX

Legal business name

IMAN J. ROSS, PHD, LPC, P.C.

Doing business as

Ross Psychological Services

Practice address

1106 Santa Fe TRL
Suite 2
Duncanville, TX 75137-3063

Phone

(469) 236-3999

Fax

(469) 293-4144

NPI assigned

Jul 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Iman J Ross, PHD

Title

President/Founder

Phone

(469) 236-3999

Specialties & licenses 3

Addresses

Other names 1

• Ross Psychological Services Doing business as

Locations

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1437446507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 SANTA FE TRL",
            "address_2": "SUITE 2",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751373063",
            "telephone_number": "469-236-3999",
            "fax_number": "469-293-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 SANTA FE TRL",
            "address_2": "SUITE 2",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751373063",
            "telephone_number": "469-236-3999",
            "fax_number": "469-293-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAN J. ROSS, PHD, LPC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "IMAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/FOUNDER",
        "authorized_official_telephone_number": "469-236-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "99184",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "6742",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "18030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ross Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.