Healthcare Provider Details

I. General information

NPI: 1649132911
Provider Name (Legal Business Name): ROSE SMERALDINE GELIN LICSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 E LIBERTY AVE APT A303
SPOKANE WA
99207-5749
US

IV. Provider business mailing address

10 LEA AVE STE 760
NASHVILLE TN
37210-3541
US

V. Phone/Fax

Practice location:
  • Phone: 802-855-4915
  • Fax:
Mailing address:
  • Phone: 201-526-8484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC61456192
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: