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General NPI Number Information
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NPI Number | 1265760904
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Entity Type | Individual
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Provider Name | AMY MICHELLE ROSENTHAL LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 75 MAIDEN LN RM 907
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City | NEW YORK
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State | NY
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Zip | 10038-4615
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Country | US
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Telephone | 929-382-4251
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Fax |
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Provider Business Mailing Address
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Address Line | 473 78TH ST APT 6
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City | BROOKLYN
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State | NY
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Zip | 11209-3408
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Country | US
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Telephone | 917-627-1511
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Fax |
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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 | 083112
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License Number State | NY
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