MEDICARE: ADINA ROSEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	72095453	NY
2	1041C0700X	Clinical Social Worker	09925804	CO

General Provider Information

NPI Number	:	1477920395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADINA ROSEN LCSW

Provider Business Mailing Address
First Line	:	7750 N UNION BLVD STE 202
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-4082
Country	:	US
Telephone Number	:	719-357-8957
Fax Number	:

Provider Business Practice Location Address
First Line	:	7750 N UNION BLVD STE 202
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-4082
Country	:	US
Telephone Number	:	719-357-8957
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2015
Last Update Date	:	02/17/2020

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Directions to “ ADINA ROSEN LCSW” Practice Location

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