Catherine Rose, LCSW
Social Worker, Clinical in Massapequa, NY. Individual provider (NPI-1).
NPI number1003548652
StatusActive
Last updated in NPPESJun 30, 2022
Details
- NPI
- 1003548652
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Catherine Rose
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2022
- Certification date
- Jun 30, 2022
- Last updated
- Jun 30, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | R032298-01 | NY | Yes |
Practice location
1211 Bucknell DriveMassapequa, NY 11758
Phone 917-282-4877
Mailing address
1211 Bucknell DriveMassapequa, NY 11758
Phone 917-282-4877
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