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

Mrs. Nettie Lynne Rose, LISWLADAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1407847403

Mrs. Nettie Lynne Rose, LISWLADAC is a Clinical Social Worker in Albuquerque, New Mexico. Qualified in 1996, 30 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New Mexico.

Years since qualifying
30
Licensed in
NM
In the registry since
2005
Specialties on file
3
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Practice location Address checks out

1610 San Pedro NE #A
Albuquerque, NM 87110
Phone: (505) 265-0753
Fax: (505) 268-5722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence C-4453 (NM)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 4198 (NM)
Mental Health Counselor Taxonomy 101YM0800X · Licence I4453 (NM)

Record details

NPI number1407847403
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISWLADAC
Sole proprietorYes
NPI enumeratedOctober 31, 2005
Last updated in NPPESSeptember 9, 2020
Certification dateSeptember 9, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Albuquerque