=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881655009
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FLORENCE W ROSENSTOCK MSW LICSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 664 MAIN STREET SUITE 58
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01002-2439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-256-1840
-----------------------------------------------------
Fax | 413-253-5306
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 296
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01004-0296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-256-1840
-----------------------------------------------------
Fax | 413-253-5306
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 1029563
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------