Provider Demographics
NPI:1275626517
Name:ROSEN, DEBRA E (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:E
Last Name:ROSEN
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 1:950 PENINSULA CORPORATE CIR
Mailing Address - Street 2:SUITE 2011
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1378
Mailing Address - Country:US
Mailing Address - Phone:561-715-2022
Mailing Address - Fax:561-558-8239
Practice Address - Street 1:950 PENINSULA CORPORATE CIR
Practice Address - Street 2:SUITE 2011
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1378
Practice Address - Country:US
Practice Address - Phone:561-715-2022
Practice Address - Fax:561-558-8239
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 44171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical