Provider Demographics
NPI:1255735874
Name:ADAMS-ROSELLE, ANNIE RYAN (LCSW)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:RYAN
Last Name:ADAMS-ROSELLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:RYAN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1500 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5216
Mailing Address - Country:US
Mailing Address - Phone:916-443-3299
Mailing Address - Fax:
Practice Address - Street 1:1500 21ST ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5216
Practice Address - Country:US
Practice Address - Phone:916-443-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA821631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical