Provider Demographics
NPI:1235913773
Name:ROSELLI, ASHLEY RACHAEL (LCSW LCADC CCS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RACHAEL
Last Name:ROSELLI
Suffix:
Gender:F
Credentials:LCSW LCADC CCS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RACHAEL
Other - Last Name:ROSELLI-BREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW LCADC CCS
Mailing Address - Street 1:168 PETERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 S WHITE HORSE PIKE STE 500
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1804
Practice Address - Country:US
Practice Address - Phone:609-561-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061577001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical