Provider Demographics
NPI:1164721858
Name:ROSEMOND, GEORGE FREDRICK JR (MA IN COUNSELING)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:FREDRICK
Last Name:ROSEMOND
Suffix:JR
Gender:M
Credentials:MA IN COUNSELING
Other - Prefix:MR
Other - First Name:GEORGE
Other - Middle Name:FREDRICK
Other - Last Name:ROSEMOND-GRIFFITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:84 FOREST HILL PKWY APT 2E
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-4721
Mailing Address - Country:US
Mailing Address - Phone:973-652-0209
Mailing Address - Fax:
Practice Address - Street 1:84 FOREST HILL PKWY
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-4707
Practice Address - Country:US
Practice Address - Phone:973-652-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00761700101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health