Ross, Susan
Ross, Susan is an individual health care provider with primary practice located at 5748 Brockton Ct Suite 4, Indianapolis IN 46220-7420. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ross, Susan can be contacted via phone (317) 946-4839.Contact Information
Primary practice address
5748 Brockton Ct Suite 4
Indianapolis IN 46220-7420
Phone: (317) 946-4839
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34005295A | Indiana |
Profile Details
| NPI number | 1710069539 |
|---|---|
| LBN Legal business name | Ross, Susan |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Dec 20th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710069539 | NPPES |
| Indiana | MEDICAID | 100270530A |
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