Provider Demographics
NPI:1275721102
Name:ROSADO, KEVIN ADOLFO (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ADOLFO
Last Name:ROSADO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 N FIELDER RD STE D
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4695
Mailing Address - Country:US
Mailing Address - Phone:817-962-0409
Mailing Address - Fax:817-900-2475
Practice Address - Street 1:715 N FIELDER RD STE D
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4695
Practice Address - Country:US
Practice Address - Phone:817-962-0409
Practice Address - Fax:817-900-2475
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15729101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional