Provider Demographics
NPI:1215522115
Name:TUCKER-SEALS, ROSANNE (LSW)
Entity type:Individual
Prefix:MRS
First Name:ROSANNE
Middle Name:
Last Name:TUCKER-SEALS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 S GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5549
Mailing Address - Country:US
Mailing Address - Phone:614-224-2988
Mailing Address - Fax:614-716-0902
Practice Address - Street 1:1280 NORTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3181
Practice Address - Country:US
Practice Address - Phone:614-484-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS00252421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical