Nicole Rose

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

000659-1 Issued in NY

Practice address

6240 Woodhaven Blvd
Rego Park, NY 11374-3733

Phone

(718) 426-8110

Fax

(718) 426-8117

NPI assigned

Apr 17, 2013

Last updated

Apr 17, 2013By the provider in NPPES

Sex

Female

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

• Queens Counseling Services LCSW, PLLC

  dba Queens Counseling Services, PLLC

  • Clinical Social Worker
  • Astoria, NY
  • NPI 1477815280
  NPD (past)

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1417391707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16517 144TH TER",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743733",
            "telephone_number": "718-426-8110",
            "fax_number": "718-426-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": "443401",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000659-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roman NP in Family Health PLLC
• Gladys Neida Roman, LCSW
• Leydi Viviana Roman, COTA
• Wallace Romero, CASAC
• Panus Romsaitong, MD
• Alan Jeffrey Rosen, DC
• Carl Jay Rosenmann
• Jeffrey Steven Rosner, DC
• Steven Ross, D.O.
• Royal Adult Daycare LLC

• Marriage & Family Therapist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.