MEDICARE: AMY ROS MS, LMHC, 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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659709806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ROS MS, LMHC, LPC

Provider Business Mailing Address
First Line	:	2285 KINGSLEY AVE STE A1
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-5133
Country	:	US
Telephone Number	:	904-300-0264
Fax Number	:

Provider Business Practice Location Address
First Line	:	2285 KINGSLEY AVE STE A1
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-5133
Country	:	US
Telephone Number	:	904-300-0264
Fax Number	:

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

Provider Enumeration Date	:	10/25/2013
Last Update Date	:	02/01/2026

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