Healthcare Provider Details

I. General information

NPI: 1487297404
Provider Name (Legal Business Name): KAREN BETH ROSEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 PALISADE ST STE 396
DOBBS FERRY NY
10522-1694
US

IV. Provider business mailing address

28 ASHLEY RD
HASTINGS ON HUDSON NY
10706-3502
US

V. Phone/Fax

Practice location:
  • Phone: 646-389-8443
  • Fax:
Mailing address:
  • Phone: 646-389-8443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number077122-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: