Provider Demographics
NPI:1316138563
Name:ROSENBERG, MARCY JOY (MA,LMHC)
Entity type:Individual
Prefix:MS
First Name:MARCY
Middle Name:JOY
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 E OAKLAND PARK BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1813
Mailing Address - Country:US
Mailing Address - Phone:954-315-1725
Mailing Address - Fax:954-315-1726
Practice Address - Street 1:2881 E OAKLAND PARK BLVD STE 317
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1813
Practice Address - Country:US
Practice Address - Phone:954-315-1725
Practice Address - Fax:954-315-1726
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-5194101YM0800X
FLMH 5914101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional