Provider Demographics
NPI:1235421827
Name:MENA, ROSMER M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSMER
Middle Name:M
Last Name:MENA
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 1:26883 FIDDLEWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-3231
Mailing Address - Country:US
Mailing Address - Phone:813-760-1126
Mailing Address - Fax:
Practice Address - Street 1:2807 W BUSCH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4518
Practice Address - Country:US
Practice Address - Phone:181-370-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL129421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty