Individual
KYLE R ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LPC, NCC
Contact information
Practice address
1360 BEVERLY ROAD, SUITE 200, MCLEAN, VA 22101
(703) 831-8300
Mailing address
703 N MARKET ST, SELINSGROVE, PA 17870-2007
(717) 921-7004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701011286
VA
101YM0800X
Mental Health Counselor
PC018564
PA
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
0701011286
VA
101YP2500X
Professional Counselor
Primary
PC018564
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017639620001
—
VA
Enumeration date
03/16/2020
Last updated
01/22/2026
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