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General NPI Number Information
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NPI Number | 1184761124
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Entity Type | Individual
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Provider Name | BARBARA LYN ROSEN PH.D.,LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 682 PROSPECT AVE SECOND FLOOR
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City | HARTFORD
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State | CT
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Zip | 06105-4238
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Country | US
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Telephone | 860-236-4116
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Fax | 860-236-4116
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Provider Business Mailing Address
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Address Line | 63 CONCORD ST
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1306
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Country | US
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Telephone | 860-233-4023
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Fax | 860-236-4116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 004899
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License Number State | CT
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