Provider Demographics
NPI:1265500995
Name:ROZSA, JUDI F (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDI
Middle Name:F
Last Name:ROZSA
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 1:770 JAMES STREET
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203
Mailing Address - Country:US
Mailing Address - Phone:315-422-0671
Mailing Address - Fax:315-422-2734
Practice Address - Street 1:770 JAMES STREET
Practice Address - Street 2:SUITE 215
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203
Practice Address - Country:US
Practice Address - Phone:315-422-0671
Practice Address - Fax:315-422-2734
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1268101YA0400X
NYPR01465111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1268OtherCASAC
NY01706147Medicaid
NY56711Medicare ID - Type Unspecified