Provider Demographics
NPI:1881841997
Name:OGAN, ROSEANNA MARIE (MSW, LCSW, QMHP)
Entity Type:Individual
Prefix:MRS
First Name:ROSEANNA
Middle Name:MARIE
Last Name:OGAN
Suffix:
Gender:F
Credentials:MSW, LCSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:PIERRA
Mailing Address - State:SD
Mailing Address - Zip Code:57501-0148
Mailing Address - Country:US
Mailing Address - Phone:605-224-5811
Mailing Address - Fax:605-224-6921
Practice Address - Street 1:803 E. DAKOTA
Practice Address - Street 2:
Practice Address - City:PIERRA
Practice Address - State:SD
Practice Address - Zip Code:57501-0148
Practice Address - Country:US
Practice Address - Phone:605-224-5811
Practice Address - Fax:605-224-6921
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2325104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5200080Medicaid