Provider Demographics
NPI:1902128945
Name:ROSEMAN, SONJA RENEE (LMSW)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:RENEE
Last Name:ROSEMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5738 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-1125
Mailing Address - Country:US
Mailing Address - Phone:269-547-2834
Mailing Address - Fax:
Practice Address - Street 1:308 W NORTH ST STE A
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3444
Practice Address - Country:US
Practice Address - Phone:269-359-0612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 372500000X
MI6801090864104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider