MEDICARE: MRS. MIRANDA E ROSENKRANTZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	097471-01	NY
2	1041C0700X	Clinical Social Worker	LICSW1141876	MA
3	1041C0700X	Clinical Social Worker	9703	CT

General Provider Information

NPI Number	:	1093252090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MIRANDA E ROSENKRANTZ LCSW

Provider Business Mailing Address
First Line	:	20 CLEVELAND ST
Second Line	:
City	:	ENFIELD
State	:	CT
Zip	:	06082-5308
Country	:	US
Telephone Number	:	860-930-7270
Fax Number	:

Provider Business Practice Location Address
First Line	:	38B GROVE ST
Second Line	:
City	:	RIDGEFIELD
State	:	CT
Zip	:	06877-4665
Country	:	US
Telephone Number	:	860-930-7270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2017
Last Update Date	:	05/19/2026

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