MEDICARE: CHARLOTTE H ROSEN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LCPC126	KS
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCPC126	KS
3	101YM0800X	Mental Health Counselor	LCPC126	KS
4	101YP2500X	Professional Counselor	LCPC126	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6270496	OTHER	KS	UNITED BEHAVIORAL HEALTH
2	32355011	OTHER	KS	BCBS OF KANSAS CITY

General Provider Information

NPI Number	:	1376603076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE H ROSEN LPC

Provider Business Mailing Address
First Line	:	11111 NALL AVE
Second Line	:	STE 103
City	:	LEAWOOD
State	:	KS
Zip	:	66211-1620
Country	:	US
Telephone Number	:	913-963-1795
Fax Number	:	913-469-9779

Provider Business Practice Location Address
First Line	:	11111 NALL AVE
Second Line	:	STE 103
City	:	LEAWOOD
State	:	KS
Zip	:	66211-1620
Country	:	US
Telephone Number	:	913-963-1795
Fax Number	:	913-469-9779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	09/11/2025

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Directions to “ CHARLOTTE H ROSEN LPC” Practice Location

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