Provider Demographics
NPI:1104194042
Name:ROSENBAUM GOWARD, ARIEL EVELYN (LCSW, C-ASWCM)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:EVELYN
Last Name:ROSENBAUM GOWARD
Suffix:
Gender:F
Credentials:LCSW, C-ASWCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 NORTH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2656
Mailing Address - Country:US
Mailing Address - Phone:512-574-1722
Mailing Address - Fax:512-843-8545
Practice Address - Street 1:1507 NORTH ST STE 1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2656
Practice Address - Country:US
Practice Address - Phone:512-574-1722
Practice Address - Fax:512-843-8545
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041C0700X
TX522861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical