Provider Demographics
NPI:1992940423
Name:PALLADINO, ROSEANNE M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROSEANNE
Middle Name:M
Last Name:PALLADINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN,
Mailing Address - State:NJ
Mailing Address - Zip Code:08736
Mailing Address - Country:US
Mailing Address - Phone:732-740-9989
Mailing Address - Fax:
Practice Address - Street 1:602 OCEANVIEW RD.
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730
Practice Address - Country:US
Practice Address - Phone:732-740-9989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCU10129001041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool