Provider Demographics
NPI:1801384805
Name:GENOVESE, ROSEMARIE (LPC, LCADC, CCS, NCC)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:GENOVESE
Suffix:
Gender:F
Credentials:LPC, LCADC, CCS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SCHANCK ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-995-7243
Mailing Address - Fax:732-866-1627
Practice Address - Street 1:70 SCHANCK ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-995-7243
Practice Address - Fax:732-866-1627
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00599500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0536911003Medicaid