MEDICARE: MELINDA ROSADO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2491	SC

General Provider Information

NPI Number	:	1265817217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA ROSADO LPC

Provider Business Mailing Address
First Line	:	895 ISLAND PARK DR
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7991
Country	:	US
Telephone Number	:	843-697-3562
Fax Number	:	877-780-1103

Provider Business Practice Location Address
First Line	:	895 ISLAND PARK DR
Second Line	:	SUITE 201
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7991
Country	:	US
Telephone Number	:	843-697-3562
Fax Number	:	877-780-1103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2015
Last Update Date	:	07/20/2015

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Directions to “ MELINDA ROSADO LPC” Practice Location

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