Provider Demographics
NPI:1063705093
Name:ANSEL, ROSEMARIE M (MSW)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:M
Last Name:ANSEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 COLUMBIA ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1905
Mailing Address - Country:US
Mailing Address - Phone:518-828-9446
Mailing Address - Fax:518-828-9450
Practice Address - Street 1:325 COLUMBIA ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1905
Practice Address - Country:US
Practice Address - Phone:518-828-9446
Practice Address - Fax:518-828-9450
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039160104100000X
MA2010940104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker