Provider Demographics
NPI:1134293749
Name:SMITH, ROSA LEADER (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:LEADER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 PARK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1436
Mailing Address - Country:US
Mailing Address - Phone:914-376-0556
Mailing Address - Fax:
Practice Address - Street 1:3302 STEUBEN AVE # 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2806
Practice Address - Country:US
Practice Address - Phone:914-281-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0332931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical