KYLE R ROSE PHD, LPC, NCC
NPI 1104452630
Counselor - Professional in Mclean, VA
About Kyle R Rose Phd, Lpc, Ncc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KYLE R ROSE PHD, LPC, NCC (NPI 1104452630) is an individual professional provider in Mclean, Virginia, licensed in Pennsylvania (PC018564) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 3
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kyle R Rose Phd, Lpc, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kyle Rose reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mechanicsville, VA 23116
- Reassigned Medicare billing, District of Columbia enrollment
- 65 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kyle Rose's NPI number?
The NPI number for Kyle Rose is 1104452630. It was assigned to this individual provider in the NPPES registry on March 16, 2020.
Where is Kyle Rose located?
Kyle Rose practices at 1360 Beverly Road, Suite 200, Mclean, VA 22101. The listed phone number is (703) 831-8300.
What is Kyle Rose's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kyle Rose enrolled in Medicare?
Yes. Kyle Rose is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kyle Rose's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kyle Rose reassigns Medicare benefits to Commonwealth Counseling Associates Inc (Mechanicsville, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kyle Rose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kyle Rose was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kyle R Rose, PHD, LPC, NCC · NPI 1104452630
Professional provider in Mclean, Virginia. Individual provider, active in the CMS NPPES registry since March 16, 2020.
## Identity
- **NPI:** 1104452630 (Entity type: Individual)
- **Enumerated:** March 16, 2020
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** PC018564 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1360 BEVERLY ROAD, SUITE 200, Mclean, VA 22101
- **Phone:** (703) 831-8300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Commonwealth Counseling Associates Inc (NPI 1851345805, Mechanicsville, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 22, 2026
- **Other identifiers:** Medicaid 30017639620001 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1104452630) · Data from the CMS NPPES public registry.