Healthcare Provider Details

I. General information

NPI: 1811733694
Provider Name (Legal Business Name): ROSINSKI THERAPY AND CONSULTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 WASHINGTON ST STE 303
SALEM MA
01970-3514
US

IV. Provider business mailing address

18 CHERRY ST
LYNN MA
01902-3105
US

V. Phone/Fax

Practice location:
  • Phone: 339-293-2781
  • Fax:
Mailing address:
  • Phone: 339-293-2781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLA RAE ROSINSKI
Title or Position: CEO
Credential: PHD, LMHC
Phone: 339-293-2781