Provider Demographics
NPI:1386836013
Name:ROOSA COUNSELING SERVICES
Entity Type:Organization
Organization Name:ROOSA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:845-342-5789
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-0758
Mailing Address - Country:US
Mailing Address - Phone:845-342-5789
Mailing Address - Fax:
Practice Address - Street 1:1 STAGE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10950
Practice Address - Country:US
Practice Address - Phone:845-783-5789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
561845OtherVALUE OPTIONS