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General NPI Number Information
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NPI Number | 1396604559
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Entity Type | Individual
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Provider Name | KANDICE ROSE LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 2225 COUNTY ROAD 90 STE 105
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City | PEARLAND
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State | TX
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Zip | 77584-4891
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Country | US
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Telephone | 979-285-9242
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Fax | 844-273-6889
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Provider Business Mailing Address
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Address Line | 2225 COUNTY ROAD 90 STE 105
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City | PEARLAND
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State | TX
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Zip | 77584-4891
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Country | US
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Telephone | 979-285-9242
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Fax | 844-273-6889
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111228
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License Number State | TX
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