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General NPI Number Information
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NPI Number | 1366717936
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Entity Type | Organization
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Legal Business Name | LIVE A LIFE BY DESIGN LCSW PLLC
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 455 CENTRAL PARK AVE SUITE 311
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City | SCARSDALE
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State | NY
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Zip | 10583-1060
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Country | US
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Telephone | 914-589-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 455 CENTRAL PARK AVE SUITE 311
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City | SCARSDALE
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State | NY
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Zip | 10583-1060
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACI ROSENBERG
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Credential | SW
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Telephone | 914-589-3588
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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 | 078494
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License Number State | NY
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