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General NPI Number Information
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NPI Number | 1619791654
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Entity Type | Individual
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Provider Name | DENISE ROSAS LCSW, CADC
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Gender | Female
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1602 W COLONIAL PKWY STE 200
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City | INVERNESS
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State | IL
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Zip | 60067-1215
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Country | US
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Telephone | 847-364-0163
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Fax | 847-589-5835
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Provider Business Mailing Address
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Address Line | 312 S HARVARD AVE
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City | ADDISON
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State | IL
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Zip | 60101-3934
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Country | US
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Telephone | 630-478-5697
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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 | 149.028111
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License Number State | IL
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