Provider Demographics
NPI:1770577645
Name:HARBESON, ROSEMARY M (LICSW)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:M
Last Name:HARBESON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HIGH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2213
Mailing Address - Country:US
Mailing Address - Phone:603-929-2137
Mailing Address - Fax:603-929-7482
Practice Address - Street 1:55 HIGH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2213
Practice Address - Country:US
Practice Address - Phone:603-929-2137
Practice Address - Fax:603-929-7482
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1214--LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423184Medicaid
P00415128Medicare PIN
NHCA1430Medicare PIN
NHRE7798Medicare PIN