Provider Demographics
NPI:1477325389
Name:ROSEN, ADAM J (LSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:J
Last Name:ROSEN
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 1:35 S SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2549
Mailing Address - Country:US
Mailing Address - Phone:201-320-1615
Mailing Address - Fax:
Practice Address - Street 1:35B S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2549
Practice Address - Country:US
Practice Address - Phone:201-588-3491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07048100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker