Provider Demographics
NPI:1992589618
Name:ROSE COUNSELING SERVICES LICENSED MENTAL HEALTH COUNSELING PLLC
Entity type:Organization
Organization Name:ROSE COUNSELING SERVICES LICENSED MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:RADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC CASAC
Authorized Official - Phone:716-432-3033
Mailing Address - Street 1:1400 SWEET HOME RD STE 6
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2777
Mailing Address - Country:US
Mailing Address - Phone:716-432-3033
Mailing Address - Fax:
Practice Address - Street 1:1400 SWEET HOME RD STE 6
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2777
Practice Address - Country:US
Practice Address - Phone:716-432-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty