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NPI Code Detail

MEDICARE: JANICE K ROSE LPC

MEDICARE: JANICE K ROSE 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
1101YM0800XMental Health Counselor82112TX

General Provider Information

NPI Number : 1710518725
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE K ROSE LPC
Provider Business Mailing Address
First Line : 8300 DOUGLAS AVE STE 800
Second Line :
City : DALLAS
State : TX
Zip : 75225-5826
Country : US
Telephone Number : 215-510-2066
Fax Number :
Provider Business Practice Location Address
First Line : 8300 DOUGLAS AVE STE 800
Second Line :
City : DALLAS
State : TX
Zip : 75225-5826
Country : US
Telephone Number : 215-510-2066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2020
Last Update Date : 12/16/2024

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