Provider Demographics
NPI:1629491022
Name:TOPAL, ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:TOPAL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 BREVARD AVE
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-7967
Mailing Address - Country:US
Mailing Address - Phone:321-350-8000
Mailing Address - Fax:321-558-7135
Practice Address - Street 1:268 BREVARD AVE
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7967
Practice Address - Country:US
Practice Address - Phone:321-350-8000
Practice Address - Fax:321-558-7135
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
FLMH18944101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No172V00000XOther Service ProvidersCommunity Health Worker