Debra Rose
Individual provider Active NPI Counselor · Sandy Hook, KY
NPI 1487833349 · NPPES record last updated Nov 7, 2014
Key facts
- NPI
- 1487833349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- RR 5 Box 800
Sandy Hook, KY 41171-9200 - Phone
- (606) 738-6163
- Fax
- (606) 738-5030
- NPI assigned
- Oct 29, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
RR 5 Box 800
Sandy Hook, KY 41171-9200
Mailing address
PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30610026 | Medicaid | KY |
Other providers in Sandy Hook, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.