Provider Demographics
NPI:1740826429
Name:MCCLEARY, ROSEANNA (MSW, PHD, LCSW, ACSW)
Entity type:Individual
Prefix:DR
First Name:ROSEANNA
Middle Name:
Last Name:MCCLEARY
Suffix:
Gender:F
Credentials:MSW, PHD, LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8108 FENTON RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7142
Mailing Address - Country:US
Mailing Address - Phone:661-204-4066
Mailing Address - Fax:
Practice Address - Street 1:7600 STENTON AVE STE 1F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3260
Practice Address - Country:US
Practice Address - Phone:215-247-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0208321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical