Provider Demographics
NPI:1528656840
Name:ROSATI, AMANDA ANN (LMSW)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:ANN
Last Name:ROSATI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2711
Mailing Address - Country:US
Mailing Address - Phone:516-205-0711
Mailing Address - Fax:
Practice Address - Street 1:790 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4516
Practice Address - Country:US
Practice Address - Phone:516-205-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105059104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty