| Doctor Name: | MR. JASON ROSA |
| NPI Number: | 1326414079 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | CSW005272 |
| Business Practice Address: | 512 Brooklawn Ave Roselle, NJ - 072032578 |
| Business Phone Number: | 6783679537 |
| Business Fax Number: | |
| Mailing Address: | 512 Brooklawn Ave, ROSELLE |
| State: | NJ |
| Postal Code: | 072032578 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2015 |
| NPI Last Update Date: | 06/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW005272 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |