Provider Demographics
NPI:1447600572
Name:ROSALINO, SUELEM COSTA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SUELEM
Middle Name:COSTA
Last Name:ROSALINO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 CHARLES ST
Mailing Address - Street 2:APT 2
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4917
Mailing Address - Country:US
Mailing Address - Phone:401-419-4846
Mailing Address - Fax:
Practice Address - Street 1:325 PUBLIC ST
Practice Address - Street 2:EQUALITY BUILDING
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2340
Practice Address - Country:US
Practice Address - Phone:401-419-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW026311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical