Provider Demographics
NPI:1306967278
Name:ROSENBERG, HARRY (LCSW)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 ROBERT TREAT DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-1617
Mailing Address - Country:US
Mailing Address - Phone:203-988-1629
Mailing Address - Fax:
Practice Address - Street 1:810 ROBERT TREAT DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-1617
Practice Address - Country:US
Practice Address - Phone:203-988-1629
Practice Address - Fax:203-288-3655
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0016121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical