Provider Demographics
NPI:1265608350
Name:DEVARAJ, ROZARIO CHEVANA (LCSWR CASAC)
Entity type:Individual
Prefix:MR
First Name:ROZARIO
Middle Name:CHEVANA
Last Name:DEVARAJ
Suffix:
Gender:M
Credentials:LCSWR CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43-43 BOWNE ST
Mailing Address - Street 2:QUEENS COUNSELING SERVICES
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-461-6393
Mailing Address - Fax:
Practice Address - Street 1:43-43 BOWNE ST
Practice Address - Street 2:QUEENS COUNSELING SERVICES
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-461-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9599101YA0400X
NYR051049101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)