MEDICARE: MS. MARCY JOY ROSENBERG M.A.,L.M.H.C.

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	101YM0800X	Mental Health Counselor	MH-5194	FL
2	101YP2500X	Professional Counselor	MH 5914	FL
3	101YM0800X	Mental Health Counselor	MH 5914	FL

General Provider Information

NPI Number	:	1316138563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARCY JOY ROSENBERG M.A.,L.M.H.C.

Provider Business Mailing Address
First Line	:	2881 E OAKLAND PARK BLVD STE 317
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1813
Country	:	US
Telephone Number	:	954-315-1725
Fax Number	:	954-315-1726

Provider Business Practice Location Address
First Line	:	2881 E OAKLAND PARK BLVD STE 317
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1813
Country	:	US
Telephone Number	:	954-315-1725
Fax Number	:	954-315-1726

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/03/2021

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