Provider Demographics
NPI:1477000263
Name:ROSE, CHEVELLE THOMPSON (MSW,CSW)
Entity Type:Individual
Prefix:MRS
First Name:CHEVELLE
Middle Name:THOMPSON
Last Name:ROSE
Suffix:
Gender:F
Credentials:MSW,CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S BROAD ST
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6447
Mailing Address - Country:US
Mailing Address - Phone:504-233-8182
Mailing Address - Fax:504-821-1001
Practice Address - Street 1:200 S BROAD ST
Practice Address - Street 2:SUITE 8A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6447
Practice Address - Country:US
Practice Address - Phone:504-233-8182
Practice Address - Fax:504-821-1001
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13052104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker