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NPI Code Detail

MEDICARE: MRS. CAROLYN MARIE ROSE LMHC

MEDICARE: MRS. CAROLYN MARIE 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 CounselorMH14779FL

Other Identifiers

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

General Provider Information

NPI Number : 1780187823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN MARIE ROSE LMHC
Provider Business Mailing Address
First Line : CHRYSALIS HEALTH
Second Line : 230 SOUTH DIXIE HWY
City : LAKE WORTH
State : FL
Zip : 33460
Country : US
Telephone Number : 561-533-6640
Fax Number : 561-533-6882
Provider Business Practice Location Address
First Line : 230 S DIXIE HWY
Second Line :
City : LAKE WORTH
State : FL
Zip : 33460-4154
Country : US
Telephone Number : 561-533-6640
Fax Number : 561-533-6882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2018
Last Update Date : 03/15/2018

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Directions to “ MRS. CAROLYN MARIE ROSE LMHC” Practice Location

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