Individual
MR. ANDREW JUSTIN BAKER ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC, QMHP-A, LAC
Contact information
Practice address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
(859) 813-5394
Mailing address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
(859) 813-5394
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
—
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/07/2017
Last updated
02/13/2023
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