Charles Brad Rose, LPC
Individual provider Active NPI Professional Counselor · Lansing, MI
NPI 1457725244 · NPPES record last updated Apr 27, 2020
Key facts
- NPI
- 1457725244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6401011149 (MI)
- Practice address
- 4710 W Saginaw Hwy Ste 1
Lansing, MI 48917-2654 - Phone
- (517) 684-0577
- NPI assigned
- Nov 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
535 W Rouse St
Lansing, MI 48910-4430
Phone (517) 944-0463
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122003024 | MI | Practitioner - Mental Health Counselor | 1052763455 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401011149 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charlies Counseling LLC | Professional | Current |
Accepting new patients |
| A New Day Counseling Consulting and Community Services | Counselor | Current |
Accepting new patients |
| Fountain of Wisdom and Hope LLC | Counselor | Past |
Accepting new patients |
Locations
4710 W Saginaw Hwy
Ste 1
Lansing, MI 48917
Phone (517) 816-2800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401011149 | MI | Yes |
Addresses
Primary practice location
4710 W Saginaw Hwy Ste 1
Lansing, MI 48917-2654
Mailing address
PO Box 10
Mason, MI 48854-0010
Phone (517) 676-9788
Other practice location 1
4472 Cricket Ridge Dr
apartment 102
Holt, MI 48842-2924
Phone (517) 944-0463
Other providers in Lansing, MI
- Bradley F Ropp
- Rori'S Haven, LLC
- Colorgio Rosas
- Enrique Rosas
- Bradley Arthur Rose
- Kelly Rose
- Terri Lynn Rose
- Frank Rosenbaum
- Mark Rosenberg
- Melissa Rosenberg
All providers in Lansing, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.