Provider Demographics
NPI:1992563878
Name:ROSENBERG, JULIE (AMFT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 S WALNUT ST STE C6
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-2617
Mailing Address - Country:US
Mailing Address - Phone:575-527-5770
Mailing Address - Fax:575-532-1928
Practice Address - Street 1:151 S WALNUT ST STE C6
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-2617
Practice Address - Country:US
Practice Address - Phone:575-527-5770
Practice Address - Fax:575-532-1928
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCAMF0224811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty