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

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