Provider Demographics
NPI:1902877343
Name:ROSENFELD, SHELLEY LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:LYNNE
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-2220
Mailing Address - Country:US
Mailing Address - Phone:609-653-8600
Mailing Address - Fax:609-829-5054
Practice Address - Street 1:222 NEW RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1299
Practice Address - Country:US
Practice Address - Phone:609-653-8600
Practice Address - Fax:609-653-8612
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 03336103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical