David John Roseborough, PH.D., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12199 Issued in MN

Practice address

2230 Como Ave
Saint Paul, MN 55108-1720

Phone

(651) 635-0095

Fax

(651) 635-0454

NPI assigned

Dec 8, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Home Society & Family Services

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1588715304
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1861552259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "651-635-0095",
            "fax_number": "651-635-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "651-635-0095",
            "fax_number": "651-635-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBOROUGH",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800000972",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Horwath Rose, RN ANP MA
• Emily Rose, MD
• Kimberly Rose, MS
• Richard M Rose, MD
• Sarah Nicole Rose
• Frayda Ilene Rosen, PSYD
• Mary Leah Genevieve Rosen
• Leigh Amy Rosenberg, MSW, LGSW
• Tammie Singer Rosenbloom, LICSW
• Freeman Newton Rosenblum, DDS

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.