| Kevin Rose Pllc | |
|
42189 Ann Arbor Rd E Plymouth MI 48170-4370 | |
| (734) 776-1605 | |
| Not Available |
| Full Name | Kevin Rose Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 42189 Ann Arbor Rd E, Plymouth, Michigan |
| Authorized Official Name and Position | Kevin William Rose (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7347761605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Rose Pllc 17387 Brody Ave Allen Park MI 48101-3417 Ph: (734) 776-1605 | Kevin Rose Pllc 42189 Ann Arbor Rd E Plymouth MI 48170-4370 Ph: (734) 776-1605 |
| NPI Number | 1720638711 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 09/12/2019 |
| Medicare PECOS PAC ID | 4284066333 |
|---|---|
| Medicare Enrollment ID | O20191112001688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720638711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kevin W Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245369057 PECOS PAC ID: 1850680604 Enrollment ID: I20160517002420 |
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