Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marvel Larose

Individual provider Foster Care Agency · NPI 1407209620

Marvel Larose is a Nurse Practitioner in Randolph, Massachusetts. Qualified in 2024, 2 years ago. Practices with Supportive Behavioral Care of MA LLC, a 106-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
2
Licensed in
MA
In the registry since
2016
Specialties on file
2

Practice location Address checks out

217 Chestnut St
Randolph, MA 02368-2407
Phone: (857) 991-0110
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foster Care Agency (primary) Taxonomy 253J00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence RN2292446 (MA)

Record details

NPI number1407209620
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 22, 2016
Last updated in NPPESDecember 5, 2025
Certification dateDecember 5, 2025
Mailing address101 S Main St, Randolph, MA 02368-4896

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Supportive Behavioral Care Of Ma Llc — 106 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Randolph