Individual
DANA JO LA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, LADC
Contact information
Practice address
29 MADISON ST, RUTLAND, VT 05701-5004
(802) 345-9495
(802) 775-9698
Mailing address
PO BOX 216, DORSET, VT 05251-0216
(802) 867-2437
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000141
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
103454
VT
101YM0800X
Mental Health Counselor
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1124
—
VT
01
—
19888
BLUECROSS & BLUE SHIELD
VT
01
—
613355
MVP HEALTH PLAN
VT
Enumeration date
08/08/2006
Last updated
09/11/2025
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