Provider Demographics
NPI:1710499116
Name:LONG, ROSALYN FARINELLA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:FARINELLA
Last Name:LONG
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 1:100 PARKS ST APT 25
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4838
Mailing Address - Country:US
Mailing Address - Phone:508-801-0184
Mailing Address - Fax:
Practice Address - Street 1:71 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2533
Practice Address - Country:US
Practice Address - Phone:508-543-1873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2193161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical