Provider Demographics
NPI:1497644926
Name:ROSS, REBEKAH ELISE REID (LCSW)
Entity type:Individual
Prefix:
First Name:REBEKAH ELISE
Middle Name:REID
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HOL MAR CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-5507
Mailing Address - Country:US
Mailing Address - Phone:770-630-1929
Mailing Address - Fax:
Practice Address - Street 1:50 HOL MAR CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5507
Practice Address - Country:US
Practice Address - Phone:770-630-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0088771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical