Active NPI
Rose Marie Deroche, LCSW, M.ED.
- Clinical Social Worker
- Hartford, CT
National Provider Identifier
1881894830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 006055
- Practice address
- 639 Prospect Ave
Hartford, CT 06105-4276 - Phone
- (860) 286-8674
- NPI assigned
- Jul 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 006055 | CT | Primary |
Addresses
Primary practice location
639 Prospect Ave
Hartford, CT 06105-4276
Mailing address
639 Prospect Avenue
West Hartford, CT 06105
Phone (860) 286-8674
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006055 | CT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195171200000",
"number": "1881894830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "639 PROSPECT AVENUE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "06105",
"telephone_number": "860-286-8674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "639 PROSPECT AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061054276",
"telephone_number": "860-286-8674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROCHE",
"first_name": "ROSE",
"middle_name": "MARIE",
"credential": "LCSW, M.ED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-18",
"last_updated": "2007-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "006055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.