Provider Demographics
NPI:1598946915
Name:ROSSI, JEAN STEENERSON (LCSW-C, LICSW)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:STEENERSON
Last Name:ROSSI
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 1:5 BITTERROOT CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1770
Mailing Address - Country:US
Mailing Address - Phone:301-929-1456
Mailing Address - Fax:301-929-1866
Practice Address - Street 1:5 BITTERROOT CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-1770
Practice Address - Country:US
Practice Address - Phone:301-929-1456
Practice Address - Fax:301-929-1866
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD046611041C0700X
DCLC3010701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCLC301070OtherDC LICENSE
MD04661OtherMARYLAND LICENSE