Stephanie Roseboro, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00119466 Issued in NC

Practice address

4825 Commercial Plaza St Apt 91a
Winston Salem, NC 27104-4671

Phone

(704) 692-0207

NPI assigned

Jun 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stephanie Roseboro Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1588044994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 COMMERCIAL PLAZA ST APT 91A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044671",
            "telephone_number": "704-692-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 COMMERCIAL PLAZA ST APT 91A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044671",
            "telephone_number": "704-692-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBORO",
        "first_name": "STEPHANIE",
        "credential": "CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "00119466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BORD OF LICENSED PROFESSIONAL COUNSELORS",
            "identifier": "A11664",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ROSEBORO",
            "credential": "LPCA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jessica Savidge Rose, CRNA
• Lucy Rose, MD
• Ryann McGough Rose
• Scott Wilson Rose, MD
• Tiffany Humphreys Rose, NP
• Jennifer Roberts Rosen, PA-C
• Nicholas Rosen
• Robert Dean Rosen, M.D.
• Daryl A Rosenbaum, MD
• Ruth Louise Rosenbaum, M.ED., NCC, LPC

• All providers in Winston Salem, NC
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.