Active NPI 1104452630 Individual Practitioner Male Practitioner

Dr. Kyle R Rose , PhD, LPC, NCC

Counselor - Professional • Mclean, VA

Professional Overview & Biography Verified Profile Summary

Dr. Kyle Rose, PhD, LPC, NCC is a registered healthcare professional specializing in Counselor - Professional in Mclean, VA. Practice services are available at 1360 BEVERLY ROAD, SUITE 200 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1360 Beverly Road, Suite 200

Mclean, VA 22101

Telephone 7038318300

Associated Practice Facility / Clinic

🏢 Granato Group, Inc. Facility NPI 1497810816

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Mclean, VA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 14.7 Yrs

Regional Practice Density

5 Specialists

Practicing in Mclean, VA (6609 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-01-22

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License PA PC018564

Definition to come...

Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

State License VA 0701011286

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License PA PC018564

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License VA 0701011286

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

30017639620001 (VA)

Secondary Practice Locations

703 N Market St

Selinsgrove, PA 178702007

Phone: 7179217004

313 W Liberty St Ste F

Lancaster, PA 176032799

Phone: 7179217004

1005 N Glebe Rd Ste 525

Arlington, VA 222015792

Phone: 8042076737

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners

Kathleen Matay , MA, LPC, CCTP

Counselor - Professional

NPI 1043817943

Master of Arts, Licensed Professional Counselor, CCTP

Dr. Halima Al-Qawasmi , MD

Psychiatry & Neurology - Psychiatry

NPI 1225423577

Doctor of Medicine (M.D.)

Stephanie Logan , LCSW

Social Worker - Clinical

NPI 1275104499

Licensed Clinical Social Worker

Lara Hammock , LCSW

Social Worker - Clinical

NPI 1326717851

Licensed Clinical Social Worker

Dr. Kratel Ruiz-Washington , PsyD

Psychologist - Clinical

NPI 1346785102

Doctor of Psychology (Psy.D.)

Terri Pilkerton , MAED, NCC

Counselor - Mental Health

NPI 1366901803

MAED, National Certified Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Business Mailing Address January 22, 2026

Registered at 703 N MARKET ST, SELINSGROVE, PA 178702007 (Tel: 7179217004)

👤

Provider Name / Credentials Updated January 22, 2026

Recorded as KYLE ROSE, PHD, LPC, NCC

👤

Provider Name / Credentials Updated November 28, 2023

Recorded as KYLE ROSE, LPC, NCC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 28, 2023

Counselor (License #0701011286 in VA)

✅

NPI Profile Active March 16, 2020

NPI status registered as active in NPPES database

📍

Updated Practice Location March 16, 2020

Registered at 1360 BEVERLY ROAD, SUITE 200, MCLEAN, VA 22101 (Tel: 7038318300)

📍

Updated Business Mailing Address March 16, 2020

Registered at 1360 BEVERLY ROAD, SUITE 200, MCLEAN, VA 22101 (Tel: 7038318300)

👤

Provider Name / Credentials Updated March 16, 2020

Recorded as KYLE ROSE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 16, 2020

Counselor

🟢

Initial NPI Registration & Enumeration March 16, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104452630

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 16, 2020

Last Update: January 22, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

703 N Market St

Selinsgrove, PA 178702007

Phone: 7179217004

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.