Provider Demographics
NPI:1881780500
Name:ROSCH, GEORGE WILLIAM III (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:ROSCH
Suffix:III
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 BURLINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1848
Mailing Address - Country:US
Mailing Address - Phone:805-524-1769
Mailing Address - Fax:805-524-2053
Practice Address - Street 1:3585 MAPLE STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3504
Practice Address - Country:US
Practice Address - Phone:805-524-1769
Practice Address - Fax:805-524-2053
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical