Provider Demographics
NPI:1861224933
Name:ROSEN, MICOL GIOVANELLA (LMSW)
Entity type:Individual
Prefix:
First Name:MICOL
Middle Name:GIOVANELLA
Last Name:ROSEN
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 1:5827 PICASSO PL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-3912
Mailing Address - Country:US
Mailing Address - Phone:512-413-3137
Mailing Address - Fax:
Practice Address - Street 1:5827 PICASSO PL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-3912
Practice Address - Country:US
Practice Address - Phone:512-413-3137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59640104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker