Provider Demographics
NPI:1982618468
Name:CHANEY, ROSE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:CHANEY
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 1:400 E FORDHAM RD
Mailing Address - Street 2:SEARS BUILDING 5TH FLOOR BRONX MENTAL HEALTH OF HIP
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5039
Mailing Address - Country:US
Mailing Address - Phone:718-364-3500
Mailing Address - Fax:
Practice Address - Street 1:400 E FORDHAM RD
Practice Address - Street 2:SEARS BUILDING 5TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5039
Practice Address - Country:US
Practice Address - Phone:718-364-3500
Practice Address - Fax:718-367-2092
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04976711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical