Healthcare Provider Details

I. General information

NPI: 1134333834
Provider Name (Legal Business Name): BARBARA WEISBAUM ROZENFELD L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MACARTHUR BLVD STE 404
MUNSTER IN
46321-2915
US

IV. Provider business mailing address

1917 N BURLING ST
CHICAGO IL
60614-5123
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-2995
  • Fax: 219-836-4075
Mailing address:
  • Phone: 312-951-6442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34002816A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: