Lisa Chong Rose, LPCC
Counselor, Mental Health in Roseville, MN. Individual provider (NPI-1).
NPI number1750748422
StatusActive
Last updated in NPPESJun 14, 2021
Details
- NPI
- 1750748422
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Lisa Chong Rose
- Credential
- LPCC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2016
- Certification date
- Jun 14, 2021
- Last updated
- Jun 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 2851 | MN | Yes |
Other names
- Lisa Chong Jou (Former Name)
Practice location
2680 Snelling Ave N Ste 200Roseville, MN 55113-1879
Phone 651-364-9381 · Fax 651-364-9382
Mailing address
2680 Snelling Ave N Ste 200Roseville, MN 55113-1879
Phone 651-364-9381 · Fax 651-364-9382
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