Provider Demographics
NPI:1760251623
Name:EMERSON-FOX, ROSANN (EDS, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ROSANN
Middle Name:
Last Name:EMERSON-FOX
Suffix:
Gender:F
Credentials:EDS, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4166 HIGHWAY N
Mailing Address - Street 2:
Mailing Address - City:ROBERTSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63072-1304
Mailing Address - Country:US
Mailing Address - Phone:309-532-1584
Mailing Address - Fax:
Practice Address - Street 1:4166 HIGHWAY N
Practice Address - Street 2:
Practice Address - City:ROBERTSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63072-1304
Practice Address - Country:US
Practice Address - Phone:309-532-1584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0091811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty