Provider Demographics
NPI:1043737232
Name:RECINE, ROSALYNN CARLA (LICSW, MSW)
Entity Type:Individual
Prefix:
First Name:ROSALYNN
Middle Name:CARLA
Last Name:RECINE
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:ROSALYNN
Other - Middle Name:CARLA
Other - Last Name:SCIANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, MSW
Mailing Address - Street 1:1525 NW 57TH ST UNIT 504
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5632
Mailing Address - Country:US
Mailing Address - Phone:630-336-4290
Mailing Address - Fax:
Practice Address - Street 1:1525 NW 57TH ST UNIT 504
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5632
Practice Address - Country:US
Practice Address - Phone:630-336-4290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60739937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02181984OtherBIRTHDATE