| Carrie Rosen Lcsw Llc | |
|
2471 W 1675 S West Haven UT 84401-6766 | |
| (808) 226-9546 | |
| Not Available |
| Full Name | Carrie Rosen Lcsw Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2471 W 1675 S, West Haven, Utah |
| Authorized Official Name and Position | Carrie Rosen (OWNER) |
| Authorized Official Contact | 8082269546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carrie Rosen Lcsw Llc 2471 W 1675 S West Haven UT 84401-6766 Ph: (808) 226-9546 | Carrie Rosen Lcsw Llc 2471 W 1675 S West Haven UT 84401-6766 Ph: (808) 226-9546 |
| NPI Number | 1821864612 |
|---|---|
| Provider Enumeration Date | 12/01/2023 |
| Last Update Date | 02/03/2024 |
| Certification Date | 02/03/2024 |
| Medicare PECOS PAC ID | 4688014293 |
|---|---|
| Medicare Enrollment ID | O20240430002217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821864612 | NPI | - | NPPES |
| 20190826359681 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Carrie A Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861635021 PECOS PAC ID: 3779633458 Enrollment ID: I20240430002300 |
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