Provider Demographics
NPI:1437669041
Name:FRIDAY, ROSETTA A (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSETTA
Middle Name:A
Last Name:FRIDAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 CLIPPER CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2656
Mailing Address - Country:US
Mailing Address - Phone:513-484-2326
Mailing Address - Fax:
Practice Address - Street 1:2975 CLIPPER CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2656
Practice Address - Country:US
Practice Address - Phone:513-484-2326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0068151041C0700X
OHS.1451139104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker