Provider Demographics
NPI:1851925549
Name:ROSE, SARAH (LLPC, RAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:LLPC, RAC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:LETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC, RAC
Mailing Address - Street 1:181 EMMETT ST W
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-2963
Mailing Address - Country:US
Mailing Address - Phone:269-441-1960
Mailing Address - Fax:269-965-4773
Practice Address - Street 1:181 EMMETT ST W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-2963
Practice Address - Country:US
Practice Address - Phone:269-441-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223938101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional