Provider Demographics
NPI:1720195670
Name:HERRING, ROSA HOOD (LCSW-C)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:HOOD
Last Name:HERRING
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10715 TRAFTON DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1429
Mailing Address - Country:US
Mailing Address - Phone:301-499-0869
Mailing Address - Fax:301-499-9275
Practice Address - Street 1:1300 MERCANTILE LN
Practice Address - Street 2:SUITE 136-G
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5327
Practice Address - Country:US
Practice Address - Phone:301-335-4708
Practice Address - Fax:301-499-9572
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11759101YM0800X
DCLC301809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMEDICAIDMedicaid