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General NPI Number Information
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NPI Number | 1841859220
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Entity Type | Individual
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Provider Name | STEFANI ROSADO LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 324 CLARK ST FL 2
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City | WORCESTER
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State | MA
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Zip | 01606-1214
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Country | US
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Telephone | 508-791-4976
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Fax |
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Provider Business Mailing Address
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Address Line | 125 FRANKLIN ST APT 2408
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City | WORCESTER
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State | MA
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Zip | 01608-1474
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Country | US
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Telephone | 203-578-7571
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 224584
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License Number State | MA
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