Provider Demographics
NPI:1447215504
Name:ROZMAN, ROBERT J (LSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:ROZMAN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 INSURANCE ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2760
Mailing Address - Country:US
Mailing Address - Phone:724-678-2568
Mailing Address - Fax:
Practice Address - Street 1:250 INSURANCE ST STE 204
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2760
Practice Address - Country:US
Practice Address - Phone:724-678-2568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012275L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01898514Medicaid
PA01898514Medicaid