1225130735 NPI number — MARGARET P. ROSE LCSW

Table of content: MARGARET P. ROSE LCSW (NPI 1225130735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225130735 NPI number — MARGARET P. ROSE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSE
Provider First Name:
MARGARET
Provider Middle Name:
P.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSE
Provider Other First Name:
MEG
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1225130735
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 573
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELAWARE WATER GAP
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18327-0573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-640-6984
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 WARING DR # 573
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELAWARE WATER GAP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18327-8724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-640-6984
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0004756 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW019821 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 140004756CT01 . This is a "ANTHEM BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11244299 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: CW019821 . This is a "PA LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 103466744 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 268814 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 642337HYZ . This is a "MEDICARE NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P2751167 . This is a "CONNECTICARE/UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".




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