Provider Demographics
NPI:1356659189
Name:ROSE & ASSOCIATES OF NEW YORK, INC.
Entity Type:Organization
Organization Name:ROSE & ASSOCIATES OF NEW YORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPH, LMHC
Authorized Official - Phone:917-763-9108
Mailing Address - Street 1:2080 1ST AVE
Mailing Address - Street 2:SUITE 2208
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4326
Mailing Address - Country:US
Mailing Address - Phone:917-763-9108
Mailing Address - Fax:212-831-1078
Practice Address - Street 1:2080 1ST AVE
Practice Address - Street 2:SUITE 2208
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4326
Practice Address - Country:US
Practice Address - Phone:917-763-9108
Practice Address - Fax:212-831-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000619101YA0400X, 101YM0800X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty