Provider Demographics
NPI:1356942262
Name:ROSEMAN, SHIRLEY (LCSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:ROSEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 N FEDERAL HWY # 307
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6042
Mailing Address - Country:US
Mailing Address - Phone:954-618-7724
Mailing Address - Fax:
Practice Address - Street 1:275 SUNSHINE DR
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1842
Practice Address - Country:US
Practice Address - Phone:954-598-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW195721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty