Clint Ross, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

MH19899 Issued in FL

Practice address

5610 14TH Ave S
Gulfport, FL 33707-3419

Phone

(270) 604-3016

NPI assigned

Apr 20, 2011

Last updated

Dec 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Lifeskills, Inc.

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1669401816

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1518258920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 14TH AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337073419",
            "telephone_number": "270-604-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 14TH AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337073419",
            "telephone_number": "270-604-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CLINT",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH19899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30604011",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Probeck Chiropractic Clinic, Inc.
• Robert V Probeck, DC
• Shannon Marie Reissman, LMT
• Melissa Lynne Roley, MS
• April Rose, AGACNP
• Robert Ryan, ATR, LMHC
• Hillary Ann Savage, R.D., L.D.
• Ashley Scott
• Mark Matthew Sieg I, CAP, LCSW
• Silverlining BC & T Inc.

• Professional Counselor in Gulfport, FL
• Providers in Gulfport, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.