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NPI Code Detail

MEDICARE: MR. STEPHEN JOSEPH ROOS LPCC-S LCDC-III

MEDICARE: MR. STEPHEN JOSEPH ROOS LPCC-S LCDC-III
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
1101YM0800XMental Health CounselorE.4194-SUPVOH

General Provider Information

NPI Number : 1356546576
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN JOSEPH ROOS LPCC-S LCDC-III
Provider Business Mailing Address
First Line : 12395 MCCRACKEN RD STE A-UP
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-2967
Country : US
Telephone Number : 216-587-6727
Fax Number : 216-587-8347
Provider Business Practice Location Address
First Line : 12395 MCCRACKEN RD STE A-UP
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-2967
Country : US
Telephone Number : 216-587-6727
Fax Number : 216-587-8347
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 03/30/2022

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