Individual provider Active NPI

Anthony Rose, CADC-R

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1063157584
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A18300 Issued in NC
Practice address
211 E Six Forks Rd Ste 117
Raleigh, NC 27609-7753
Phone
(919) 833-8899
NPI assigned
Apr 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 27404 NC
Mental Health Counselor 101YM0800X A18300 NC Primary

Addresses

Primary practice location

211 E Six Forks Rd Ste 117
Raleigh, NC 27609-7753

Mailing address

211 E Six Forks Rd Ste 117
Raleigh, NC 27609-7753
Phone (919) 833-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251030001432 NC Practitioner - Mental Health Counselor 5092204024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

211 E Six Forks Rd
Suite 117
Raleigh, NC 27609-7753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27404NCMDAddiction (Substance Use Disorder) Counselor
A18300NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Healthcare, PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1063157584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD STE 117",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097753",
            "telephone_number": "919-833-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD STE 117",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097753",
            "telephone_number": "919-833-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ANTHONY",
        "credential": "CADC-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-29",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "27404",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.