Ross, Thalia
Ross, Thalia is an sole proprietor health care provider with primary practice located at 1912 Central Dr Suite A, Bedford TX 76021-5894. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ross, Thalia can be contacted via phone (817) 718-8576.Contact Information
Primary practice address
1912 Central Dr Suite A
Bedford TX 76021-5894
Phone: (817) 718-8576
Fax: (817) 451-1763
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 30812 | Texas |
Profile Details
| NPI number | 1104049055 |
|---|---|
| LBN Legal business name | Ross, Thalia |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2007 |
| Last updated | Dec 29th, 2021 - about 4 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 | 1104049055 | NPPES |
| Texas | Other | TXB131437 | MEDICARE |
| Texas | MEDICAID | 184916803 | MEDICARE |
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