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General NPI Number Information
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NPI Number | 1821414681
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Entity Type | Organization
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Legal Business Name | ROSE WIERZBA COUNSELING LLC
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 220 3RD COURT SE SUITE 4
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City | DEMOTTE
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State | IN
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Zip | 46310-8534
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Country | US
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Telephone | 219-964-3773
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Fax | 219-987-3372
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Provider Business Mailing Address
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Address Line | 220 3RD COURT SE SUITE 4
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City | DEMOTTE
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State | IN
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Zip | 46310-8534
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Country | US
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Telephone | 219-964-3773
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Fax | 219-987-3372
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Authorized Official
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Title or Position | OWNER
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Name | ROSE WIERZBA
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Credential | LMHC
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Telephone | 219-964-3773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 39002472A
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License Number State | IN
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