Provider Information for 1366676173
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mr. ROBERT MATTHEW ROSS MS, NCC, LPC
Sex: Male
NPI: 1366676173
Last Updated: 2021-09-28
Certification Date: 2021-09-28
Certification Date: 2021-09-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366676173 | ||||||||
| Enumeration Date | 2009-05-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 166 JOHNSON ST FL 2 PITTSTON, PA 18640-1034 United States Phone: 570-332-2475 | Fax:570-332-2475 | ||||||||
| Primary Practice Address | 317 LUZERNE AVE WEST PITTSTON, PA 18643-2233 United States Phone: 570-332-2475 | Fax:570-332-2475 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|