=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760726137
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROSALYN J NORENSBERG MSW, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/24/2012
-----------------------------------------------------
Last Update Date | 11/24/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8327 W ATLANTIC BLVD
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33071-7452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-755-9797
-----------------------------------------------------
Fax | 954-755-5436
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8327 W ATLANTIC BLVD
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33071-7452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-755-9797
-----------------------------------------------------
Fax | 954-755-5436
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ROSALYN J NORENSBERG
-----------------------------------------------------
Credential | MSW
-----------------------------------------------------
Telephone | 954-755-9797
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW 72
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------