MEDICARE: ROSEMANS COUNSELING & CONTRACTING SERVICES PLLC

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	251S00000X	Community/Behavioral Health Agency	A13649	NC

General Provider Information

NPI Number	:	1598242794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSEMANS COUNSELING & CONTRACTING SERVICES PLLC

Provider Business Mailing Address
First Line	:	3028 LEROY ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-7633
Country	:	US
Telephone Number	:	704-495-4482
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 MONROE RD STE 107D
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-7533
Country	:	US
Telephone Number	:	704-495-4482
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. TWANETTA ANTOINETTE ROSEMAN
Credential	:	MA, NCC, LPC-A, LCAS
Telephone Number	:	704-495-4482

Provider Enumeration Date	:	07/20/2018
Last Update Date	:	07/20/2018

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