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General NPI Number Information
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NPI Number | 1225744022
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Entity Type | Individual
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Provider Name | MICHAEL ROSE LPC
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Gender | Male
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 38100 COLORADO AVE
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City | AVON
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State | OH
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Zip | 44011-1031
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Country | US
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Telephone | 440-961-1008
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Fax |
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Provider Business Mailing Address
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Address Line | 8761 LINCOLNSHIRE BLVD
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City | STRONGSVILLE
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State | OH
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Zip | 44149-1149
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Country | US
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Telephone | 440-876-3716
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.2405771
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License Number State | OH
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