Provider Demographics
NPI:1447525795
Name:ROSE, ROCHELLE MARCELLA (MSW, PLCSW)
Entity type:Individual
Prefix:MISS
First Name:ROCHELLE
Middle Name:MARCELLA
Last Name:ROSE
Suffix:
Gender:F
Credentials:MSW, PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 TWISTED HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-5100
Mailing Address - Country:US
Mailing Address - Phone:910-642-3598
Mailing Address - Fax:910-642-3815
Practice Address - Street 1:598 TWISTED HICKORY RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-5100
Practice Address - Country:US
Practice Address - Phone:910-642-3598
Practice Address - Fax:910-642-3815
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0070141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical