Provider Demographics
NPI:1538670757
Name:ROSE, NATALIE MERKUR (LCSW-C; LICSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MERKUR
Last Name:ROSE
Suffix:
Gender:F
Credentials:LCSW-C; LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WILLOWBROOK CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2501
Mailing Address - Country:US
Mailing Address - Phone:240-813-8723
Mailing Address - Fax:
Practice Address - Street 1:6288 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4119
Practice Address - Country:US
Practice Address - Phone:240-813-8723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-15
Last Update Date:2017-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical