Provider Demographics
NPI:1861022923
Name:ROSZELL, ERICA LYN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LYN
Last Name:ROSZELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 STORM HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-3707
Mailing Address - Country:US
Mailing Address - Phone:443-905-6222
Mailing Address - Fax:
Practice Address - Street 1:207 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1189
Practice Address - Country:US
Practice Address - Phone:410-758-8750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25704104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker