Active NPI
Shandra Ross
- Mental Health Counselor
- Raleigh, NC
National Provider Identifier
1801285218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A11380
- Practice address
- 1708 Trawick Rd Ste 101
Raleigh, NC 27604-3897 - Phone
- (919) 896-7536
- Fax
- (866) 543-8773
- NPI assigned
- Jan 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20902 | NC | |
| Mental Health Counselor | 101YM0800X | A11380 | NC | Primary |
Addresses
Primary practice location
1708 Trawick Rd Ste 101
Raleigh, NC 27604-3897
Mailing address
1708 Trawick Rd Ste 101
Raleigh, NC 27604-3897
Phone (919) 896-7536
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20902 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A11380 | NC | MD | Mental Health Counselor |
| 11380 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421884800000",
"number": "1801285218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1708 TRAWICK RD STE 101",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276043897",
"telephone_number": "919-896-7536",
"fax_number": "866-543-8773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 TRAWICK RD STE 101",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276043897",
"telephone_number": "919-896-7536",
"fax_number": "866-543-8773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "SHANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-22",
"last_updated": "2015-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "20902",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A11380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.