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General NPI Number Information
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NPI Number | 1922371855
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Entity Type | Individual
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Provider Name | MICHELE EMILIA ROSELLO LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 65 PROSPECT AVENUE 9W
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City | HEWLETT
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State | NY
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Zip | 11557
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Country | US
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Telephone | 516-732-7476
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 JEFFERSON ST
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City | BALDWIN
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State | NY
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Zip | 11510-4744
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Country | US
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Telephone | 516-286-4620
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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 | 074122-1
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License Number State | NY
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