Larry James Rose, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000000484 Issued in TN

Practice address

2600 State Line Rd
Elizabethton, TN 37643-7204

Phone

(423) 542-4245

Fax

(423) 542-4369

NPI assigned

Sep 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tricare Behavorial Health LLC

  dba Stress Care Associates

  • Community/Behavioral Health Agency
  • Kingsport, TN
  • NPI 1891844973
  NPD (past)
• Tricare Behavorial Health, LLC Group

  • Mental Health Counselor
  • Kingsport, TN
  • NPI 1750599650
  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1366637365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 STATE LINE RD",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376437204",
            "telephone_number": "423-542-4245",
            "fax_number": "423-542-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 STATE LINE RD",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376437204",
            "telephone_number": "423-542-4245",
            "fax_number": "423-542-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LARRY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000000484",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Dawn Roberts
• Robertson Dental PLLC (Robertson Dental)
• Mark Alan Robertson, D.D.S.
• Diane Lynn Roche, PA
• Kaylee Rose, M.S., CF-SLP
• Faith Russell, PT, DPT
• Christine Marie Sager, M.D.
• Kimberly Ann Sams, ASSOC
• Robert Lewis Sams, OD
• Wendy Carol Sams, LPN

• Clinical Social Worker in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.