MEDICARE: FLORENCE BRISTY ROZARIO M.A, LGPC

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	101YP2500X	Professional Counselor	LGPC00840	DC
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518634187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE BRISTY ROZARIO M.A, LGPC

Provider Business Mailing Address
First Line	:	8503 PAXTON CT
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2645
Country	:	US
Telephone Number	:	301-741-5869
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 L ST NW STE 101-279
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-4909
Country	:	US
Telephone Number	:	617-455-8359
Fax Number	:

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

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	08/23/2021

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