Provider Demographics
NPI:1295040921
Name:MITCHELL-COSGROVE, RONDA SUE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:RONDA
Middle Name:SUE
Last Name:MITCHELL-COSGROVE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7679 PLANTATION CIR
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34201-2066
Mailing Address - Country:US
Mailing Address - Phone:941-468-1721
Mailing Address - Fax:
Practice Address - Street 1:3890 E STATE ROAD 64
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-9040
Practice Address - Country:US
Practice Address - Phone:941-468-1721
Practice Address - Fax:941-360-0627
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW91461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical