Kyle R Rose, PHD, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC018564 Issued in PA

Practice address

1360 Beverly Road, Suite 200
McLean, VA 22101

Phone

(703) 831-8300

NPI assigned

Mar 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: granatogroup.kylerose@144557.advancedmd-direct.com

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.

• Commonwealth Counseling Associates Inc

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  Counselor, DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1104452630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N MARKET ST",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178702007",
            "telephone_number": "717-921-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BEVERLY ROAD, SUITE 200",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-831-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 N Market St",
            "address_purpose": "LOCATION",
            "city": "Selinsgrove",
            "state": "PA",
            "postal_code": "178702007",
            "country_code": "US",
            "telephone_number": "717-921-7004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 W Liberty St Ste F",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176032799",
            "country_code": "US",
            "telephone_number": "717-921-7004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 N Glebe Rd Ste 525",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222015792",
            "country_code": "US",
            "telephone_number": "804-207-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KYLE",
        "middle_name": "R",
        "credential": "PHD, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-16",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011286",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC018564",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701011286",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC018564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017639620001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Jeanne Richardson, CRNA
• Richey Fas LLC
• Rising Sun of the Nile Inc
• Monique Maria Rizvi, M.D.
• James Michael Ronis, DDS
• Phillip Leon Rosenblum, MSW, LCSW
• Michael A Ross, MD
• Harvey Rubenstein, M.D.
• Miguel Leandro Rufail, M.D., PH.D.
• Joseph A. Ruzzo, DDS

• Professional Counselor in McLean, VA
• Providers in McLean, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.