| Ronicia Rose, | |
| 1308 N Main St, Crown Point, IN 46307-2719 | |
| (219) 663-6353 | |
| Not Available | 
| Full Name | Ronicia Rose | 
|---|---|
| Gender | Female | 
| Speciality | Social Worker - Clinical | 
| Location | 1308 N Main St, Crown Point, Indiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1174021505 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34005851A (Indiana) | Primary | 
| Entity Name | Southlake Community Mental Health Center Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1821081290 PECOS PAC ID: 5991600355 Enrollment ID: O20031231000117 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ronicia Rose, 1308 N Main St, Crown Point, IN 46307-2719 Ph: () - | Ronicia Rose, 1308 N Main St, Crown Point, IN 46307-2719 Ph: (219) 663-6353 | 
| Dr. Trevaughn Davis-neal, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9800 Connecticut Dr, Crown Point, IN 46307 Phone: 866-220-0238 Fax: 866-222-0631 | |
| Miss Melissa D Patterson-wright, MSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999 | |
| Mira M May, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999 | |
| Robert G Crytzer, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2050 N Main St Ste C, Crown Point, IN 46307 Phone: 219-662-3300 Fax: 219-662-3301 | |
| Mrs. Susan Marcus, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9150 East 109th Street, Crown Point, IN 46307 Phone: 219-689-9883 | |
| Margaret Cousineau, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 11035 Broadway, Crown Point, IN 46307 Phone: 877-467-6881 | |
| Yolanda Coriano-tinoco, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 160 S West St, Crown Point, IN 46307 Phone: 219-613-9111 |