Provider Demographics
NPI:1770463416
Name:GONZALEZ, ROSA (LMSW)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505C N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2028
Mailing Address - Country:US
Mailing Address - Phone:864-232-2734
Mailing Address - Fax:864-232-8126
Practice Address - Street 1:505C N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-2028
Practice Address - Country:US
Practice Address - Phone:864-232-2734
Practice Address - Fax:864-232-8126
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health