Provider Demographics
NPI:1841512175
Name:BRIGHT, ROSE MARIE (MSW, LICSW, PIP)
Entity type:Individual
Prefix:MS
First Name:ROSE
Middle Name:MARIE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:MSW, LICSW, PIP
Other - Prefix:MS
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:BICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:1026 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:AL
Mailing Address - Zip Code:35760-8870
Mailing Address - Country:US
Mailing Address - Phone:256-509-7771
Mailing Address - Fax:256-999-0729
Practice Address - Street 1:605 E LAUREL ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2043
Practice Address - Country:US
Practice Address - Phone:256-999-0727
Practice Address - Fax:256-999-0729
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1555-1545C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-03508OtherBLUE CROSS BLUE SHIELD
630638946001OtherTRICARE SOUTH
AL511-03508OtherBC/BS OF ALABAMA LOCATION ID