Individual provider Active NPI

Larry Edwin Ross, L.P.C.

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1568510097
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1753 Issued in AZ
Practice address
1144 E McDowell Rd
Suite 301
Phoenix, AZ 85006-2664
Phone
(602) 344-5651
Fax
(602) 344-5578
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1753 AZ Primary

Addresses

Primary practice location

1144 E McDowell Rd
Suite 301
Phoenix, AZ 85006-2664

Mailing address

PO Box 5177
Phoenix, AZ 85010-5177
Phone (602) 344-5651

Other identifiers 1

IdentifierTypeStateIssuer
704983MedicaidAZ

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

LicenseStateTypeSpecialty
1753AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568510097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5177",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850105177",
            "telephone_number": "602-344-5651",
            "fax_number": "602-344-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 E MCDOWELL RD",
            "address_2": "SUITE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062664",
            "telephone_number": "602-344-5651",
            "fax_number": "602-344-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "LARRY",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "1753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "704983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.