Provider Demographics
NPI:1699262121
Name:BURDEN, ROSANNA JEAN (LCSW, MT-BC)
Entity type:Individual
Prefix:
First Name:ROSANNA
Middle Name:JEAN
Last Name:BURDEN
Suffix:
Gender:F
Credentials:LCSW, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PLEASANT VALLEY DR
Mailing Address - Street 2:STE 210
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-5683
Mailing Address - Country:US
Mailing Address - Phone:830-267-4575
Mailing Address - Fax:830-267-4575
Practice Address - Street 1:113 PLEASANT VALLEY DR
Practice Address - Street 2:STE 210
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-5683
Practice Address - Country:US
Practice Address - Phone:830-267-4575
Practice Address - Fax:830-267-4575
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX587361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical