MEDICARE: MARGARET KROSE, MSW, & HERBERT KROSE, MSW, INC.

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	LCS8340, LCS481	CA

General Provider Information

NPI Number	:	1811160716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARGARET KROSE, MSW, & HERBERT KROSE, MSW, INC.

Provider Business Mailing Address
First Line	:	500 E OLIVE AVENUE
Second Line	:	SUITE 310
City	:	BURBANK
State	:	CA
Zip	:	91501-2171
Country	:	US
Telephone Number	:	818-843-7279
Fax Number	:	818-843-1933

Provider Business Practice Location Address
First Line	:	500 E OLIVE AVENUE
Second Line	:	SUITE 310
City	:	BURBANK
State	:	CA
Zip	:	91501-2171
Country	:	US
Telephone Number	:	818-843-7279
Fax Number	:	818-843-1933

Authorized Official
Title or Position	:	V.P.
Name	:	HERBERT KROSE
Credential	:
Telephone Number	:	818-843-7279

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	04/11/2008

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