Rose M Krouse, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1600728 Issued in OH

Practice address

541 Sr 664 N Suite C
Logan, OH 44313

Phone

(740) 385-6594

Fax

(740) 774-6617

NPI assigned

Jun 14, 2011

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

• Ms. Rose M Ellerbrock Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1750676151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 SR 664 N SUITE C",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "44313",
            "telephone_number": "740-385-6594",
            "fax_number": "740-774-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "ROSE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "I.1600728",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "ELLERBROCK",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Klucar
• Beth Kluding, QMHS
• David Knight
• Brett Knott Jr., LICDC-CS, LPC
• Lucinda Kraft
• Shivaprakash T Kudlapur, MD
• Taylor A Kusic, LISW
• Amy Laird
• Lancaster Surgical Associates, Inc.
• Kathleen Land

• All providers in Logan, OH
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.