Provider Demographics
NPI:1497807200
Name:ROSE-GREEN, YVONNE CHELSIA (MS, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:YVONNE
Middle Name:CHELSIA
Last Name:ROSE-GREEN
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 MEADE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7865
Mailing Address - Country:US
Mailing Address - Phone:561-684-7000
Mailing Address - Fax:561-684-4832
Practice Address - Street 1:2000 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6244
Practice Address - Country:US
Practice Address - Phone:561-684-7000
Practice Address - Fax:561-684-4832
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8248101YA0400X
FLMH 8248101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ093ZOtherBLUE CROSS BLUE SHIELD
FL866183OtherBEACON HEALTH OPTIONS
FL295825OtherAMERIGROUP
FLZ093ZOtherBLUE CROSS BLUE SHIELD