| Marabai Rose Counseling, Llc | |
|
4568 East State Rd 45 Bloomington IN 47408 | |
| (812) 624-1864 | |
| Not Available |
| Full Name | Marabai Rose Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4568 East State Rd 45, Bloomington, Indiana |
| Authorized Official Name and Position | Marabai Rose Beczkiewicz (TIN OWNER) |
| Authorized Official Contact | 8126241864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marabai Rose Counseling, Llc 3405 N Russell Rd Bloomington IN 47408-9215 Ph: (812) 624-1864 | Marabai Rose Counseling, Llc 4568 East State Rd 45 Bloomington IN 47408 Ph: (812) 624-1864 |
| NPI Number | 1316499395 |
|---|---|
| Provider Enumeration Date | 10/26/2016 |
| Last Update Date | 11/08/2016 |
| Medicare PECOS PAC ID | 2668751900 |
|---|---|
| Medicare Enrollment ID | O20161109001904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316499395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34007534A (Indiana) | Primary |
| Provider Name | Marabai R Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548717028 PECOS PAC ID: 5193004430 Enrollment ID: I20161109002067 |
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