Provider Demographics
NPI:1356747653
Name:DE LA ROSA, RALPH BREWER (LMSW)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:BREWER
Last Name:DE LA ROSA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 W 145TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-4122
Mailing Address - Country:US
Mailing Address - Phone:212-368-4100
Mailing Address - Fax:212-614-9811
Practice Address - Street 1:274 W 145TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-4122
Practice Address - Country:US
Practice Address - Phone:212-368-4100
Practice Address - Fax:212-614-9811
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092091-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical