Provider Demographics
NPI:1144597733
Name:ROSENBERG, SCOTT (LCSW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
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 1:2268 31ST ST UNIT 5606
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3091
Mailing Address - Country:US
Mailing Address - Phone:347-620-5433
Mailing Address - Fax:347-658-3522
Practice Address - Street 1:2268 31ST ST UNIT 5606
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11105-3091
Practice Address - Country:US
Practice Address - Phone:347-620-5433
Practice Address - Fax:347-658-3522
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-26
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0791041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical