Active NPI
Tony G. Rose, NCC, LPCC
- Professional Counselor
- Elizabethtown, KY
National Provider Identifier
1376863548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- KY1113
- Practice address
- 110 Village Dr
Elizabethtown, KY 42701-2423 - Phone
- (270) 401-4055
- Fax
- (270) 763-9618
- NPI assigned
- Jun 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | KY1113 | KY | Primary |
Addresses
Primary practice location
110 Village Dr
Elizabethtown, KY 42701-2423
Mailing address
110 Village Dr
Elizabethtown, KY 42701-2423
Phone (270) 401-4055
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY1113 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1376863548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 VILLAGE DR",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012423",
"telephone_number": "270-401-4055",
"fax_number": "270-763-9618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 VILLAGE DR",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012423",
"telephone_number": "270-401-4055",
"fax_number": "270-763-9618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "TONY",
"middle_name": "G.",
"credential": "NCC, LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-10",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "KY1113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.