Derose Family Counseling, LLC.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2958 Issued in WI

Legal business name

DEROSE FAMILY COUNSELING, LLC.

Practice address

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

Phone

(262) 633-1235

Fax

(262) 633-1236

NPI assigned

Mar 7, 2012

Last updated

Mar 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Talia Derose, PHDNPI 1417183989

Title

Certified Psychotherapist

Phone

(262) 633-1235

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Talia Catherine Derose, MSW

  • Professional Counselor
  • Racine, WI
  • NPI 1417183989
  NPD (past) Authorized official
• Michael Derose, LCSW

  • Clinical Social Worker
  • Mount Pleasant, WI
  • NPI 1295101574
  NPD (past)

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1437423563",
    "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": {
        "organization_name": "DEROSE FAMILY COUNSELING, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "DEROSE",
        "authorized_official_first_name": "TALIA",
        "authorized_official_title_or_position": "CERTIFIED PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "262-633-1235",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "2958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John T Dembowiak, LPT
• Gail Jean Deno
• Autumn R Depaoli, LPC-IT
• Monserratt Itzayana Derby, LPC
• Tia Derflinger, PA-C
• Francesca Derose
• Nicolet Derose, D.D.S
• Talia Catherine Derose, MSW
• Becky Derosia
• Matthew Deschler, PHARM. D.

• Community/Behavioral Health Agency in Racine, WI
• Providers in Racine, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.