Talia Catherine Derose, MSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4827-125 Issued in WI

Practice address

316 5TH St
Suite 1
Racine, WI 53403-4606

Phone

(262) 633-1235

Fax

(262) 633-1236

NPI assigned

Jun 10, 2009

Last updated

Sep 4, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Derose Family Counseling, LLC.

  • Community/Behavioral Health Agency
  • Racine, WI
  • NPI 1437423563
  NPD (past) Authorized official

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1417183989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 5TH ST",
            "address_2": "SUITE 1",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534034606",
            "telephone_number": "262-633-1235",
            "fax_number": "262-633-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 5TH ST",
            "address_2": "SUITE 1",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534034606",
            "telephone_number": "262-633-1235",
            "fax_number": "262-633-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "TALIA",
        "middle_name": "CATHERINE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4827-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monserratt Itzayana Derby, LPC
• Tia Derflinger, PA-C
• Derose Family Counseling, LLC.
• Francesca Derose
• Nicolet Derose, D.D.S
• Becky Derosia
• Matthew Deschler, PHARM. D.
• Nichole Deschler, PTA
• Britt Mae Devusic, PT
• Theresa Dewalt

• Professional Counselor in Racine, WI
• Providers in Racine, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.