Healthcare Provider Details

I. General information

NPI: 1871569418
Provider Name (Legal Business Name): DIANNE MICHELE ROSSI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ALEXANDER STREET 1214
YONKERS NY
10701-7568
US

IV. Provider business mailing address

1 ALEXANDER STREET 1214
YONKERS NY
10701-7568
US

V. Phone/Fax

Practice location:
  • Phone: 914-346-7490
  • Fax:
Mailing address:
  • Phone: 914-346-7490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR053233-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: