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NPI Code Detail

MEDICARE: MS. ERICKA ROSE MHC

MEDICARE: MS. ERICKA ROSE MHC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1609124130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERICKA ROSE MHC
Provider Business Mailing Address
First Line : 6 CHELSEA PL
Second Line :
City : CLIFTON PARK
State : NY
Zip : 12065-3216
Country : US
Telephone Number : 518-691-0732
Fax Number :
Provider Business Practice Location Address
First Line : 6 CHELSEA PL
Second Line :
City : CLIFTON PARK
State : NY
Zip : 12065-3216
Country : US
Telephone Number : 518-691-0732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2012
Last Update Date : 08/15/2012

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