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NPI Code Detail

MEDICARE: MRS. MEGAN I. ROSE LMHC

MEDICARE: MRS. MEGAN I. ROSE LMHC
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 Counselor001658IA

General Provider Information

NPI Number : 1417378456
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN I. ROSE LMHC
Provider Business Mailing Address
First Line : 1811 BOYSON RD
Second Line :
City : HIAWATHA
State : IA
Zip : 52233-1270
Country : US
Telephone Number : 319-540-7123
Fax Number :
Provider Business Practice Location Address
First Line : 1811 BOYSON RD
Second Line :
City : HIAWATHA
State : IA
Zip : 52233-1270
Country : US
Telephone Number : 319-250-1267
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2013
Last Update Date : 12/10/2021

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