Provider Demographics
NPI:1356021968
Name:ANDREA ROSE COUNSELING
Entity type:Organization
Organization Name:ANDREA ROSE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:TARANTELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:570-660-8171
Mailing Address - Street 1:926 HURON AVE
Mailing Address - Street 2:
Mailing Address - City:RENOVO
Mailing Address - State:PA
Mailing Address - Zip Code:17764-1142
Mailing Address - Country:US
Mailing Address - Phone:570-800-2288
Mailing Address - Fax:570-531-1144
Practice Address - Street 1:926 HURON AVE
Practice Address - Street 2:
Practice Address - City:RENOVO
Practice Address - State:PA
Practice Address - Zip Code:17764-1142
Practice Address - Country:US
Practice Address - Phone:570-800-2288
Practice Address - Fax:570-531-1144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health