Provider Demographics
NPI:1104477082
Name:ROSE, MORGAN (LSW, LLMSW)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:LSW, LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TENNEY AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2268
Mailing Address - Country:US
Mailing Address - Phone:440-390-3312
Mailing Address - Fax:
Practice Address - Street 1:400 TENNEY AVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2268
Practice Address - Country:US
Practice Address - Phone:440-390-3312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker