Provider Demographics
NPI:1790900421
Name:ROSSI, EUGENIA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EUGENIA
Middle Name:M
Last Name:ROSSI
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 1:322 MORNINGSTAR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-2831
Mailing Address - Country:US
Mailing Address - Phone:718-876-1710
Mailing Address - Fax:
Practice Address - Street 1:1036 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3622
Practice Address - Country:US
Practice Address - Phone:908-240-8496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO45909-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical