Provider Demographics
NPI:1285745919
Name:ABBRUZZESE, ROSEMARIE A (LICSW)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:A
Last Name:ABBRUZZESE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 1/2 WALKER ROAD
Mailing Address - Street 2:
Mailing Address - City:FOSTER
Mailing Address - State:RI
Mailing Address - Zip Code:02825-1275
Mailing Address - Country:US
Mailing Address - Phone:401-678-6515
Mailing Address - Fax:401-397-7025
Practice Address - Street 1:1255 OAKLAWN AVENUE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-2649
Practice Address - Country:US
Practice Address - Phone:401-678-6515
Practice Address - Fax:401-397-7025
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW014361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI30119OtherBLUE SHIELD PROVIDER #
RI30119OtherBLUE SHIELD PROVIDER #