Provider Demographics
NPI:1710414115
Name:ROSENFIELD, LYDIA (LICSW)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:ROSENFIELD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CUMMINGS CTR STE 433H
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6199
Mailing Address - Country:US
Mailing Address - Phone:978-810-2335
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 433H
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6199
Practice Address - Country:US
Practice Address - Phone:978-810-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1273281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical