Provider Demographics
NPI:1851567333
Name:ROSE, DINA (LCSW)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BELL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1404
Mailing Address - Country:US
Mailing Address - Phone:828-296-7445
Mailing Address - Fax:828-296-7445
Practice Address - Street 1:16 BELL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1404
Practice Address - Country:US
Practice Address - Phone:828-296-7445
Practice Address - Fax:828-296-7445
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005283101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)