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General NPI Number Information
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NPI Number | 1356659189
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Entity Type | Organization
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Legal Business Name | ROSE & ASSOCIATES OF NEW YORK, INC.
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 2080 1ST AVE SUITE 2208
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City | NEW YORK
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State | NY
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Zip | 10029-4326
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Country | US
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Telephone | 917-763-9108
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Fax | 212-831-1078
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Provider Business Mailing Address
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Address Line | 2080 1ST AVE SUITE 2208
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City | NEW YORK
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State | NY
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Zip | 10029-4326
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Country | US
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Telephone | 917-763-9108
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Fax | 212-831-1078
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANE WILLIS
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Credential | DPH, LMHC
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Telephone | 917-763-9108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 000619
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 000619
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000619
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License Number State | NY
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