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General NPI Number Information
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NPI Number | 1821295486
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Entity Type | Individual
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Provider Name | MITCHELL J ROSENZWEIG
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Gender | Male
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 2501 MACHINE ST STE 306
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City | ABERDEEN PROVING GROUNDS
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State | MD
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Zip | 21005
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Country | US
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Telephone | 667-441-0955
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Fax |
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Provider Business Mailing Address
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Address Line | 66 S MAIN ST
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City | PORT DEPOSIT
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State | MD
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Zip | 21904-1726
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Country | US
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Telephone | 667-441-0955
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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 | LW 60576429
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801060547
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1650
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW92225
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License Number State | CA
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