MEDICARE: MADELINE ROSE LMHC-D

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1851980049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE ROSE LMHC-D

Provider Business Mailing Address
First Line	:	95 ALLENS CREEK RD STE 1-113
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 ALLENS CREEK RD STE 1-113
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3250
Country	:	US
Telephone Number	:	585-534-8090
Fax Number	:

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

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	02/02/2026

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