Provider Demographics
NPI:1316236284
Name:ROSENFELD, CARLA (MA, MHC)
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:MA, MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17561 HILLSIDE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5733
Mailing Address - Country:US
Mailing Address - Phone:718-558-0850
Mailing Address - Fax:718-558-0860
Practice Address - Street 1:17561 HILLSIDE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5733
Practice Address - Country:US
Practice Address - Phone:718-558-0850
Practice Address - Fax:718-558-0860
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18P78343101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health