Individual
CHERYL ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHC-LP, CASAC-T
Contact information
Practice address
102-35 64TH RD, GF, FOREST HILLS, NY 11375-1545
(929) 900-5624
(646) 844-5961
Mailing address
102-35 64TH RD, GF, FOREST HILLS, NY 11375
(929) 900-5624
(646) 844-5961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
P105777
NY
Other
Enumeration date
10/08/2020
Last updated
07/30/2022
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