Provider Demographics
NPI:1255072815
Name:ROSETTI, BRENNA M'LEE (LMSW)
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:M'LEE
Last Name:ROSETTI
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 1:194 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:PERKINSTON
Mailing Address - State:MS
Mailing Address - Zip Code:39573-3421
Mailing Address - Country:US
Mailing Address - Phone:601-528-2797
Mailing Address - Fax:
Practice Address - Street 1:118 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39406-0001
Practice Address - Country:US
Practice Address - Phone:601-266-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker