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General NPI Number Information
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NPI Number | 1487909545
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Entity Type | Organization
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Legal Business Name | SHARON R. ROSE LMSW CAAC COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 28359 ALINE DR
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City | WARREN
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State | MI
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Zip | 48093-2675
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Country | US
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Telephone | 586-741-5111
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Fax | 586-806-0411
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Provider Business Mailing Address
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Address Line | PO BOX 1496
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City | WARREN
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State | MI
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Zip | 48090-1496
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Country | US
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Telephone | 586-741-5111
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Fax | 586-806-0411
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. SHARON ROSE
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Credential | LMSW
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Telephone | 586-741-5111
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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