Provider Demographics
NPI:1841487675
Name:ONATE, ROSALOU S (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:ROSALOU
Middle Name:S
Last Name:ONATE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18410 JAMAICA AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2400
Mailing Address - Country:US
Mailing Address - Phone:718-454-6940
Mailing Address - Fax:718-264-3203
Practice Address - Street 1:18410 JAMAICA AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2400
Practice Address - Country:US
Practice Address - Phone:718-454-6940
Practice Address - Fax:718-264-3203
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053965-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN002Y1OtherEMPIRE
NY05421JOtherGHI
NYP80616Medicare UPIN