Individual provider Active NPI

Jennifer Heather Ross, MA, ATR-BC, LPC

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1578899522
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC005268 Issued in PA
Practice address
319 Vine St
Philadelphia, PA 19106-1122
Phone
(215) 284-0162
NPI assigned
Oct 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC005268 PA Primary

Addresses

Primary practice location

319 Vine St
Philadelphia, PA 19106-1122

Mailing address

3605 Berry Ave
Drexel Hill, PA 19026-2317
Phone (215) 284-0162

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PC005268PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1578899522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 BERRY AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190262317",
            "telephone_number": "215-284-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 VINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061122",
            "telephone_number": "215-284-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JENNIFER",
        "middle_name": "HEATHER",
        "credential": "MA, ATR-BC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.