Harold Bernard Rose III, LCSW
Social Worker, Clinical in Poplar Bluff, MO. Individual provider (NPI-1).
NPI number1265071484
StatusActive
Last updated in NPPESJan 27, 2025
Details
- NPI
- 1265071484
- Entity type
- Individual (NPI-1)
- Name
- Mr. Harold Bernard Rose III
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 6, 2020
- Certification date
- Jan 27, 2025
- Last updated
- Jan 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 2018026062 | MO | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
1600 W Maud St Ste 2Poplar Bluff, MO 63901-4726
Phone 573-840-0615 · Fax 573-872-4797
Mailing address
1600 W Maud St Ste 2Poplar Bluff, MO 63901-4726
Phone 573-840-0615 · Fax 573-872-4797
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