Provider Demographics
NPI:1013211341
Name:ABRAHAM, ROSETTA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ROSETTA
Middle Name:
Last Name:ABRAHAM
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 1:30 MELMORE GDNS
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-2507
Mailing Address - Country:US
Mailing Address - Phone:973-944-4359
Mailing Address - Fax:
Practice Address - Street 1:30 MELMORE GDNS
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-2507
Practice Address - Country:US
Practice Address - Phone:973-944-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082964-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical