Healthcare Provider Details

I. General information

NPI: 1538728233
Provider Name (Legal Business Name): ERIC SCOTT ROSMITH PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18583 W THUNDERHILL PL
GOODYEAR AZ
85338-4823
US

IV. Provider business mailing address

18583 W THUNDERHILL PL
GOODYEAR AZ
85338-4823
US

V. Phone/Fax

Practice location:
  • Phone: 940-783-7329
  • Fax:
Mailing address:
  • Phone: 657-253-3950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY60751048
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number113270
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-005785
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP03025
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY9106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: