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NPI Code Detail

MEDICARE: ROSE MESICK LCPC

MEDICARE: ROSE MESICK LCPC
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 Counselor180011554IL
2101YP2500XProfessional CounselorCO

General Provider Information

NPI Number : 1780286005
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE MESICK LCPC
Provider Business Mailing Address
First Line : 4440 BARNES RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-1564
Country : US
Telephone Number : 719-319-3654
Fax Number :
Provider Business Practice Location Address
First Line : 4440 BARNES RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-1564
Country : US
Telephone Number : 719-319-3654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2020
Last Update Date : 04/28/2025

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Directions to “ ROSE MESICK LCPC” Practice Location

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