Provider Demographics
NPI:1588796551
Name:ROSEBRAUGH, YVONNE (LCSW)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:ROSEBRAUGH
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 2091
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2091
Mailing Address - Country:US
Mailing Address - Phone:256-856-8580
Mailing Address - Fax:
Practice Address - Street 1:503 W STATE ST STE A-14
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2861
Practice Address - Country:US
Practice Address - Phone:256-856-8580
Practice Address - Fax:256-330-4603
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA815411041C0700X
101YM0800X
AL4956C101YM0800X
AZ19347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical