Healthcare Provider Details

I. General information

NPI: 1114679735
Provider Name (Legal Business Name): HANNAH E ROSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST STE 201
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

17 GAP HILL DR
FLETCHER NC
28732-9444
US

V. Phone/Fax

Practice location:
  • Phone: 202-681-1348
  • Fax:
Mailing address:
  • Phone: 443-845-1573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. HANNAH ELISE ROSE
Title or Position: OWNER
Credential: LCPC
Phone: 443-845-1573