Provider Demographics
NPI:1386629509
Name:ROSENTHAL, AUGUSTA T (MSW)
Entity Type:Individual
Prefix:MS
First Name:AUGUSTA
Middle Name:T
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BISHOP RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02770-1801
Mailing Address - Country:US
Mailing Address - Phone:508-763-9577
Mailing Address - Fax:
Practice Address - Street 1:19 COUNTY RD
Practice Address - Street 2:
Practice Address - City:MATTAPOISETT
Practice Address - State:MA
Practice Address - Zip Code:02739-1584
Practice Address - Country:US
Practice Address - Phone:508-758-3754
Practice Address - Fax:508-758-3755
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1023861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000026565OtherHEALTH NET
MA102386OtherBOARD OF SOC WK REGIS
MA1851349Medicaid
1891570OtherMASS BEHAVIORAL HEALTH
RI209009OtherBLUE CROSS BLUE SHIELD
6251540OtherUNITED BEHAVIORAL HEALTH
025376OtherVMC BEHAVIORAL HEALTHCARE
MAP03979OtherBLUE CROSS BLUE SHIELD
0007362127OtherAETNA
9052725OtherPRIVATE HEALTHCARE SYSTEM
000000026565OtherBOSTON MEDICAL CENTER
102386OtherTUFTS
1041382OtherCIGNA
114148OtherVALUE OPTIONS
1891570OtherMASS BEHAVIORAL HEALTH