| Jim Rose, Lcpc, Llc | |
|
1 W Church St Frederick MD 21701-5991 | |
| (443) 691-5078 | |
| Not Available |
| Full Name | Jim Rose, Lcpc, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1 W Church St, Frederick, Maryland |
| Authorized Official Name and Position | James Rose (DIRECTOR) |
| Authorized Official Contact | 4436915078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jim Rose, Lcpc, Llc 31 W Patrick St Apt 401 Frederick MD 21701-5563 Ph: (436) 915-0784 | Jim Rose, Lcpc, Llc 1 W Church St Frederick MD 21701-5991 Ph: (443) 691-5078 |
| NPI Number | 1477293371 |
|---|---|
| Provider Enumeration Date | 03/30/2022 |
| Last Update Date | 03/30/2022 |
| Certification Date | 03/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477293371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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