Active NPI
Sandra Rose, M.ED.
- Marriage & Family Therapist
- Worcester, MA
National Provider Identifier
1366701591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT141488
- Practice address
- 548 Park Ave
Worcester, MA 01603-2537 - Phone
- (774) 823-1500
- NPI assigned
- May 8, 2012
- Reactivated
- Sep 4, 2025
- Last updated
- Sep 5, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT141488 | CA | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X |
Addresses
Primary practice location
548 Park Ave
Worcester, MA 01603-2537
Mailing address
2001 S Barrington Ave
Suite 309
Los Angeles, CA 90025
Phone (323) 457-3370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT141488 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1366701591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 S BARRINGTON AVE",
"address_2": "SUITE 309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90025",
"telephone_number": "323-457-3370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "548 PARK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016032537",
"telephone_number": "774-823-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "SANDRA",
"name_prefix": "Mrs.",
"credential": "M.ED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-08",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"deactivation_date": "2024-07-23",
"reactivation_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT141488",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.