Individual provider Active NPI

Deirdre Crochen Rose, LPC

  • Professional Counselor
  • Birmingham, AL
National Provider Identifier
1710412200
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3708 Issued in AL
Practice address
400 Century Park S Ste 106
Birmingham, AL 35226-3925
Phone
(205) 739-2145
Fax
(205) 606-6494
NPI assigned
Apr 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3708 AL Primary

Addresses

Primary practice location

400 Century Park S Ste 106
Birmingham, AL 35226-3925

Mailing address

400 Century Park S Ste 106
Birmingham, AL 35226-3925
Phone (205) 739-2145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226001446 AL Practitioner - Mental Health Counselor 5799205365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3708ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Insight Integrated Health Services Mental Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1710412200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTURY PARK S STE 106",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352263925",
            "telephone_number": "205-739-2145",
            "fax_number": "205-606-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTURY PARK S STE 106",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352263925",
            "telephone_number": "205-739-2145",
            "fax_number": "205-606-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DEIRDRE",
        "middle_name": "CROCHEN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "3708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.