Provider Demographics
NPI:1063655918
Name:CABANILLAS, ROSEMARY DIANE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ROSEMARY
Middle Name:DIANE
Last Name:CABANILLAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 LITTLE NECK PKWY APT 5P
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2208
Mailing Address - Country:US
Mailing Address - Phone:718-757-6412
Mailing Address - Fax:
Practice Address - Street 1:5440 LITTLE NECK PKWY APT 5P
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2208
Practice Address - Country:US
Practice Address - Phone:718-757-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07635511041C0700X
NY082245-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical