Provider Demographics
NPI:1831754613
Name:ROSAS, KAREN WARREN (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:WARREN
Last Name:ROSAS
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 1:2168 GENERAL WINSHIP DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1775
Mailing Address - Country:US
Mailing Address - Phone:478-737-1142
Mailing Address - Fax:
Practice Address - Street 1:3090 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2406
Practice Address - Country:US
Practice Address - Phone:478-737-1142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA61931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical