Provider Demographics
NPI:1316113319
Name:STATTS, ROSALIND E (CAC)
Entity type:Individual
Prefix:MRS
First Name:ROSALIND
Middle Name:E
Last Name:STATTS
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7095 ROUTE 287
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-6711
Mailing Address - Country:US
Mailing Address - Phone:570-724-5272
Mailing Address - Fax:570-724-4512
Practice Address - Street 1:7095 ROUTE 287
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-6711
Practice Address - Country:US
Practice Address - Phone:570-724-5272
Practice Address - Fax:570-724-4512
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool