Kaitlyn Abigail Rose, MSW, LCSW-SUPERVISEE

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0906013648 Issued in VA

Practice address

12923 Erlene Dr
Chester, VA 23831-4508

Phone

(254) 702-1200

NPI assigned

Oct 4, 2024

Last updated

Oct 4, 2024By 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

Other names 1

• Kaitlyn Reasland Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA, MD3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psych Associates of Maryland LLCGroup PAC ID 3971550963, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bloomhealthcenters.kaitlynrose@131200.advancedmd-direct.com

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.

• Psych Associates of Maryland LLC

  dba Bloom Health Centers

  • Psychologist
  • Timonium, MD
  • NPI 1891721981

  DC, VA

  Medicare reassignment Care Compare group NPD
• Neta, Inc.

  • Child & Adolescent Psychiatry Physician
  • Arlington, VA
  • NPI 1134506520
  NPD (past)

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

{
    "created_epoch": "1728000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1538988845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12923 ERLENE DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238314508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12923 ERLENE DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238314508",
            "telephone_number": "254-702-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KAITLYN",
        "middle_name": "ABIGAIL",
        "credential": "MSW, LCSW-SUPERVISEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0906013648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "REASLAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lilian Rodriguez-Brown
• Tory Rogers, CTRS, CDP, CMDCP
• Shabnam Ava Roozbehani, PHARMD
• Diana Rop, PHARMD
• Andrew L. Rose, M.D.
• Rochelle Rose
• Karen Marie Rosmarin, OTR/L
• Emily Rotty, PT, DPT
• Shelly Rouse
• Aria Rowshan, PA-C

• Clinical Social Worker in Chester, VA
• Providers in Chester, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.