Individual provider Active NPI

Patty Ross, LCSW

  • Mental Health Counselor
  • Coral Springs, FL
National Provider Identifier
1639418833
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW9795 Issued in FL
Practice address
11760 W Sample Rd
Suite 101
Coral Springs, FL 33065-3199
Phone
(954) 345-5644
Fax
(954) 345-5683
NPI assigned
Feb 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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 SW9795 FL Primary

Addresses

Primary practice location

11760 W Sample Rd
Suite 101
Coral Springs, FL 33065-3199

Mailing address

11760 W Sample Rd
Suite 101
Coral Springs, FL 33065-3199
Phone (954) 345-5644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130612000272 FL Practitioner - Clinical Social Worker 9436398088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Psychological Wellness IncGroup PAC ID 1951362870, 7 clinicians

Practice addresses (Care Compare)

Parkland, FL 33076
Phone (954) 345-5644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
SW9795FLMDMental Health Counselor

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1639418833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 W SAMPLE RD",
            "address_2": "SUITE 101",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653199",
            "telephone_number": "954-345-5644",
            "fax_number": "954-345-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 W SAMPLE RD",
            "address_2": "SUITE 101",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653199",
            "telephone_number": "954-345-5644",
            "fax_number": "954-345-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "PATTY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW9795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.