Organization
ROSEMEDWARDSLCSW-C, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE M EDWARDS LCSW-C (SOLE OWNER, SOLE MEMBER)
(443) 900-7145
Entity
Organization
Contact information
Practice address
2360 W JOPPA RD STE 229, LUTHERVILLE, MD 21093-4664
(443) 900-7145
Mailing address
720 HOLLEN RD, BALTIMORE, MD 21212-2718
(443) 900-7145
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11523570
CAQH
MD
05
—
333369800
—
MD
Enumeration date
08/18/2020
Last updated
08/18/2020
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