Samuel Mitchell Rosen, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C010278 Issued in NC

Practice address

10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513

Phone

(704) 360-3637

NPI assigned

Jun 11, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: samuel.rosen.1@14940.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1306250949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GATEWAY BLVD",
            "address_2": "STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175544",
            "telephone_number": "704-360-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 HARRIS OAK BLVD STE L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697513",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "SAMUEL",
        "middle_name": "MITCHELL",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Rosen, CPO
• Erica Lauren Rosen, MAOM, LAC
• Gerald Bruce Rosen, M.D.
• Kayla Rosen
• Nadine Rosen, L.P.C.
• Rachel Jennifer Rosenau, OT
• Bailey Rose Rosenbalm, MS
• Daniel L. Rosenberg, MD
• Michael A. Rosenberg, PT
• Kaitlyn Rosenblatt, M.A

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.