Healthcare Provider Details

I. General information

NPI: 1770001026
Provider Name (Legal Business Name): CLAUDIA ROSENBERG PHD LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1262 WOOD LN STE 206
LANGHORNE PA
19047-4251
US

IV. Provider business mailing address

664 LESLIE LN
YARDLEY PA
19067-4468
US

V. Phone/Fax

Practice location:
  • Phone: 267-209-3005
  • Fax:
Mailing address:
  • Phone: 267-209-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberCW016234
License Number StatePA

VIII. Authorized Official

Name: DR. CLAUDIA ROSENBERG
Title or Position: SOLE MEMBER-CLINICIAN
Credential: LCSW
Phone: 267-209-3005