Provider Demographics
NPI:1205082716
Name:ANDERSON, ROSEMARY (LCSW-C)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 JENELLES LN
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3729
Mailing Address - Country:US
Mailing Address - Phone:443-722-3680
Mailing Address - Fax:443-288-2800
Practice Address - Street 1:7715 JENELLES LN
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-3729
Practice Address - Country:US
Practice Address - Phone:443-722-3680
Practice Address - Fax:443-288-2800
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD113251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical