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General NPI Number Information
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NPI Number | 1538688833
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Entity Type | Individual
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Provider Name | ROSE FREUND MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 4050 COON RAPIDS BLVD NW
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City | COON RAPIDS
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State | MN
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Zip | 55433-2522
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Country | US
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Telephone | 763-236-7964
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Fax |
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Provider Business Mailing Address
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Address Line | 19262 E FRONT BLVD NE
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City | EAST BETHEL
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State | MN
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Zip | 55092-8523
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Country | US
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Telephone |
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 2468502
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1587
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License Number State | MN
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