Individual provider Active NPI

Rosalind Rose, L.C.S.W.

  • Mental Health Counselor
  • Jericho, NY
National Provider Identifier
1326040031
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PR021593-1 Issued in NY
Practice address
366 N Broadway
Suite 404
Jericho, NY 11753-2025
Phone
(516) 935-0068
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PR021593-1 NY Primary

Addresses

Primary practice location

366 N Broadway
Suite 404
Jericho, NY 11753-2025

Mailing address

366 N Broadway
Suite 404
Jericho, NY 11753-2025
Phone (516) 935-0068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050830000214 NY Practitioner - Clinical Social Worker 1759312721 Practice locations: Jericho, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

380 N Broadway
Suite 403
Jericho, NY 11753-2109
Phone (516) 935-0068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR021593-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326040031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 N BROADWAY",
            "address_2": "SUITE 404",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532025",
            "telephone_number": "516-935-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 N BROADWAY",
            "address_2": "SUITE 404",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532025",
            "telephone_number": "516-935-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ROSALIND",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "PR021593-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

Verify at the official NPI Registry.