Provider Demographics
NPI:1578771242
Name:ROSA, MARGARET (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:
Last Name:ROSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556
Mailing Address - Country:US
Mailing Address - Phone:347-350-3311
Mailing Address - Fax:
Practice Address - Street 1:19337 SHUMARD OAK DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAND 'O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638
Practice Address - Country:US
Practice Address - Phone:347-350-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW144190104100000X
NY07454811041C0700X
FLSW144901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty