Provider Demographics
NPI:1619791654
Name:ROSAS, DENISE (LCSW, CADC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:ROSAS
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3934
Mailing Address - Country:US
Mailing Address - Phone:630-478-5697
Mailing Address - Fax:
Practice Address - Street 1:1602 W COLONIAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-1215
Practice Address - Country:US
Practice Address - Phone:847-364-0163
Practice Address - Fax:847-589-5835
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0281111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical