MEDICARE: MS. DENISE M ROSEMOND MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	213566	MA

General Provider Information

NPI Number	:	1457443483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE M ROSEMOND MSW, LCSW

Provider Business Mailing Address
First Line	:	1746 PARKER ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01128-1286
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 STATE ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01109-4101
Country	:	US
Telephone Number	:	413-733-6661
Fax Number	:	413-733-7841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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