PHYLLIS ROSS (L.I.C.S.W) – Mental Health Counselor, NPI 1497849079

PHYLLIS ROSS (L.I.C.S.W) is a healthcare provider. based in Waban, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials L.I.C.S.W. They hold a License No. 105628 (MA). The NPI Number for PHYLLIS ROSS (L.I.C.S.W) is 1497849079

Main info

Female
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
PHYLLIS ROSS (L.I.C.S.W)
NPI
1497849079
Phone
(617) 285-8639
Address
76 GORDON ROAD
Enumeration Date
3 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6172858639
Graduation Year
1980 (46 years ago)
PAC ID
7214185024
Professional Enrollment ID
I20120920000460
Address ID
MA024681219WA76XXXRDXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for PHYLLIS ROSS (L.I.C.S.W)

  • 76, Gordon Road, Waban, West Newton, Newton, Middlesex County, Massachusetts, 02468, United States

    WABAN, MA 02468

    Phone: (617) 285-8639

    Fax: (781) 721-2113

    Type: Mailing

  • 573, Main Street, Winchester, North Dundas, Stormont, Dundas and Glengarry Counties, Eastern Ontario, Ontario, K0C 2K0, Canada

    WINCHESTER, MA 01890

    Phone: (782) 729-4010

    Fax: (781) 721-2113

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120920000460IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour25217$0
View full utilization report →

Insurance plans in this area (ZIP 02468)

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Reviews

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Frequently asked questions

What is the registry number for PHYLLIS ROSS (L.I.C.S.W)?
The registry entry for PHYLLIS ROSS (L.I.C.S.W) shows NPI 1497849079.
Is PHYLLIS ROSS (L.I.C.S.W)'s NPI status active today?
Active status means PHYLLIS ROSS (L.I.C.S.W)'s NPI record is not deactivated in the public file.
What services align with PHYLLIS ROSS (L.I.C.S.W)'s listing?
PHYLLIS ROSS (L.I.C.S.W)'s public classification highlights Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit PHYLLIS ROSS (L.I.C.S.W) in Waban, Massachusetts?
For routing, start with Waban, Massachusetts for PHYLLIS ROSS (L.I.C.S.W), then verify phone and hours locally.
Who maintains PHYLLIS ROSS (L.I.C.S.W)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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