MEDICARE: MR. CARL ROMANO PARLOVE ED.S, MA .L.P.C. NCC

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	101YP2500X	Professional Counselor	6401009724	MI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	C-00002	MI

General Provider Information

NPI Number	:	1679552913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL ROMANO PARLOVE ED.S, MA .L.P.C. NCC

Provider Business Mailing Address
First Line	:	54060 BIRCHFIELD DR W
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-1393
Country	:	US
Telephone Number	:	248-842-4253
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 WALTON BLVD
Second Line	:	SUITE 212
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-6900
Country	:	US
Telephone Number	:	248-842-4253
Fax Number	:

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

Provider Enumeration Date	:	01/14/2006
Last Update Date	:	12/01/2008

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