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NPI Code Detail

MEDICARE: LAUREN IVY ROSENTHAL MS, LPC

MEDICARE: LAUREN IVY ROSENTHAL MS, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC010851PA

General Provider Information

NPI Number : 1174240246
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN IVY ROSENTHAL MS, LPC
Provider Business Mailing Address
First Line : 1634 REED ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-4741
Country : US
Telephone Number : 703-801-0876
Fax Number :
Provider Business Practice Location Address
First Line : 255 S 17TH ST FL 9
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-6209
Country : US
Telephone Number : 215-608-0040
Fax Number : 267-227-9989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2022
Last Update Date : 12/29/2023

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