# MR. ANDREW JUSTIN BAKER ROSE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1770098139
- **Gender:** Man
- **Credential:** CSAC, QMHP-A, LAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 0710103608 | VA | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 175461 | KY | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 86000431A | IN | — |
| 101YM0800X | Mental Health Counselor | 0732008841 | VA | — |
| 171M00000X | Case Manager/Care Coordinator | — | KY | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |

## Other

- **Enumeration date:** 12/07/2017
- **Last updated:** 02/13/2023