Douglass, Rose M

Douglass, Rose M is an individual health care provider with primary practice located at 104 S Front Ave , Prestonsburg KY 41653-1614. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Douglass, Rose M can be contacted via phone (606) 886-8572.

Contact Information

Primary practice address
104 S Front Ave Prestonsburg KY 41653-1614
Phone: (606) 886-8572
Fax: (606) 886-4433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 795 Kentucky

Profile Details

NPI number 1902955206
LBN Legal business name Douglass, Rose M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Feb 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902955206 NPPES
Kentucky MEDICAID 30615058

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