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General NPI Number Information
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NPI Number | 1598674608
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Entity Type | Individual
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Provider Name | STEPHANIE DE LA ROSA LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 252 WASHINGTON ST STE A1
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City | TOMS RIVER
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State | NJ
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Zip | 08753-7582
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Country | US
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Telephone | 732-966-4166
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 S BRISTOL ST APT 216
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City | SANTA ANA
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State | CA
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Zip | 92704-6759
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Country | US
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Telephone | 732-934-0107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06702800
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License Number State | NJ
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