Southern Rose Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SOUTHERN ROSE PSYCHOTHERAPY, LLC

Practice address

555 Jefferson St Ste 301
Paducah, KY 42001-1088

Phone

(971) 334-1940

NPI assigned

Mar 11, 2022

Last updated

Mar 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Megan Rose Larson, MSW, LCSWNPI 1407393150

Title

Therapist

Phone

(971) 334-1940

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Megan Rose Larson, LCSW

  • Clinical Social Worker
  • Paducah, KY
  • NPI 1407393150
  NPD Authorized official

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1962150615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 NEW HOLT RD STE D373",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017441",
            "telephone_number": "971-334-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 JEFFERSON ST STE 301",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420011088",
            "telephone_number": "971-334-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ROSE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "971-334-1940",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407393150",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "meganlarsonlcsw@southernrosepsychotherapyllc.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "2780 New Holt Rd Ste D373",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420017441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Pain and Rehabilitation Inc (Elite Pain and Spine)
• Southfork Counseling PLLC
• Southside Family Chiropractic
• Kelly Lynn Sowers
• Gracie Sparks
• Michael C Sparks, D.M.D.

• Clinical Social Worker in Paducah, KY
• Providers in Paducah, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.