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NPI Code Detail

MEDICARE: KANDICE ROSE LCSW

MEDICARE:   KANDICE  ROSE  LCSW
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
11041C0700XClinical Social Worker111228TX

General Provider Information

NPI Number : 1396604559
Entity Type Code : Individual
Provider Name (Legal Business Name) : KANDICE ROSE LCSW
Provider Business Mailing Address
First Line : 2225 COUNTY ROAD 90 STE 105
Second Line :
City : PEARLAND
State : TX
Zip : 77584-4891
Country : US
Telephone Number : 979-285-9242
Fax Number : 844-273-6889
Provider Business Practice Location Address
First Line : 2225 COUNTY ROAD 90 STE 105
Second Line :
City : PEARLAND
State : TX
Zip : 77584-4891
Country : US
Telephone Number : 979-285-9242
Fax Number : 844-273-6889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “ KANDICE ROSE LCSW” Practice Location

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