Individual provider Active NPI

Nia Marletta Rose, LMHC

  • Professional Counselor
  • Concord, NC
National Provider Identifier
1548568264
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
14179 Issued in NC
Practice address
219 Lephillip Court NE
Concord, NC 28025-2900
Phone
(704) 721-5551
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH10662 FL
Professional Counselor 101YP2500X 14179 NC Primary

Addresses

Primary practice location

219 Lephillip Court NE
Concord, NC 28025-2900

Mailing address

219 Lephillip Court NE
Concord, NC 28025-2900
Phone (704) 721-5551

Other practice location 1

3107 Hanging Rock Ct E
Jacksonville, FL 32246-3853
Phone (904) 207-4382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14179NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1548568264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 LEPHILLIP COURT NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252900",
            "telephone_number": "704-721-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 LEPHILLIP COURT NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252900",
            "telephone_number": "704-721-5551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3107 Hanging Rock Ct E",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322463853",
            "country_code": "US",
            "telephone_number": "904-207-4382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "NIA",
        "middle_name": "MARLETTA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2021-05-14",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10662",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "14179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.