Provider Demographics
NPI:1114162096
Name:ROSTECKI, RHONDA (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:ROSTECKI
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 1:3876 N 625 W
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-8548
Mailing Address - Country:US
Mailing Address - Phone:219-898-5210
Mailing Address - Fax:219-324-3424
Practice Address - Street 1:3876 N 625 W
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350
Practice Address - Country:US
Practice Address - Phone:219-898-5210
Practice Address - Fax:219-324-3424
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005413A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical