Healthcare Provider Details

I. General information

NPI: 1477928695
Provider Name (Legal Business Name): ROSEMARY NEADERHISER LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 12/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 LIBERTY ST
CLAY CENTER KS
67432-1528
US

IV. Provider business mailing address

1335 NW BROAD ST
MURFREESBORO TN
37129-4428
US

V. Phone/Fax

Practice location:
  • Phone: 785-632-5696
  • Fax:
Mailing address:
  • Phone: 615-896-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSCSW 2477
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: