Provider Demographics
NPI:1225130735
Name:ROSE, MARGARET P (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:P
Last Name:ROSE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEG
Other - Middle Name:
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 573
Mailing Address - Street 2:
Mailing Address - City:DELAWARE WATER GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18327-0573
Mailing Address - Country:US
Mailing Address - Phone:203-640-6984
Mailing Address - Fax:
Practice Address - Street 1:30 WARING DR # 573
Practice Address - Street 2:
Practice Address - City:DELAWARE WATER GAP
Practice Address - State:PA
Practice Address - Zip Code:18327-8724
Practice Address - Country:US
Practice Address - Phone:203-640-6984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00047561041C0700X
PACW0198211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
140004756CT01OtherANTHEM BEHAVIORAL HEALTH
11244299OtherCAQH
PACW019821OtherPA LICENSE
PA103466744Medicaid
268814OtherMHN
PA642337HYZOtherMEDICARE NUMBER
P2751167OtherCONNECTICARE/UNITED BEHAVIORAL HEALTH