Provider Demographics
NPI:1174683494
Name:TOMPKINS, ROSAMOND PERKINS (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSAMOND
Middle Name:PERKINS
Last Name:TOMPKINS
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 1:10542 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111-2834
Mailing Address - Country:US
Mailing Address - Phone:703-330-1611
Mailing Address - Fax:603-369-9742
Practice Address - Street 1:8401 DORSEY CIR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-8303
Practice Address - Country:US
Practice Address - Phone:703-361-4021
Practice Address - Fax:703-369-9742
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA200532OtherANTHEM PROVIDER NUMBER