Provider Demographics
NPI:1124144373
Name:FINE, ROSALIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROSALIE
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MADISON AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5596
Mailing Address - Country:US
Mailing Address - Phone:646-960-2110
Mailing Address - Fax:
Practice Address - Street 1:515 MADISON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5596
Practice Address - Country:US
Practice Address - Phone:646-960-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0720951103TP0814X
NY072095-1103TP0814X
NJ44SC05377200103TP0814X
NYR078702-1103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis