DANA JO LA ROSE LICSW LADC NPI 1457361875

NPI Information

NPI: 1457361875
Provider Name: DANA JO LA ROSE, LICSW, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
29 MADISON ST
RUTLAND, VT
ZIP 05701
Phone: (802) 345-9495
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Dana Jo La Rose, LICSW, LADC is an addiction (substance use disorder) counselor in Rutland, VT. Dana Jo La Rose, LICSW, LADC NPI is 1457361875. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

29 MADISON ST
RUTLAND, VT
ZIP 05701-004
Phone: (802) 345-9495
Fax: (802) 775-9698

The enumeration date for this NPI number is 8/8/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	000141	VERMONT	Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	103454	VERMONT	X
3	101YM0800X	Counselor	Mental Health		VERMONT	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	613355	OTHER	VERMONT	MVP HEALTH PLAN
2	19888	OTHER	VERMONT	BLUECROSS & BLUE SHIELD
3	0VN1124	MEDICAID	VERMONT
4	LAVN1124	MEDICARE ID-TYPE UNSPECIFIED	VERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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