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Provider Information for 1548568264


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

Ms. NIA MARLETTA ROSE LMHC


Sex: Female

NPI: 1548568264
Last Updated: 2021-05-14
Certification Date: 2021-04-20

Details

NameValue
NPI1548568264
Enumeration Date2011-03-03
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 219 LEPHILLIP COURT NE
CONCORD, NC 28025-2900
United States

Phone: 704-721-5551 | Fax:
 
Primary Practice Address 219 LEPHILLIP COURT NE
CONCORD, NC 28025-2900
United States

Phone: 704-721-5551 | Fax:
 
Secondary Practice Address(es)

3107 HANGING ROCK CT E
JACKSONVILLE, FL 32246-3853
United States

Phone: 904-207-4382 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental HealthFLMH10662
Yes 101YP2500X - Counselor - ProfessionalNC14179