Lydia Rose, MPS, LADC

NPI #1801685706 in Rockford, Minnesota

Provider Information

NPI Number: 1801685706
Entity Type: Individual
Name: Lydia Rose, MPS, LADC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: MPS, LADC
Enumeration Date: May 6, 2025
Last Updated: May 6, 2025

Practice Location

Address: PO BOX 73
City: Rockford
State: Minnesota
ZIP Code: 55373-0073
Phone: (612) 208-9629

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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