Provider Demographics
NPI:1407010606
Name:ROUNSEVILLE, ANN E (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:E
Last Name:ROUNSEVILLE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MISS
Other - First Name:ANN
Other - Middle Name:E
Other - Last Name:KLEVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:DEPT OF SOCIAL WORK
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-2964
Mailing Address - Fax:617-734-1034
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:DEPT OF SOCIAL WORK
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-2964
Practice Address - Fax:617-734-1034
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1109121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical