Provider Demographics
NPI:1861617433
Name:ROSENBERG, NATALIE K (MSW, LICSW, ACSW)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:K
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MSW, LICSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3528
Mailing Address - Country:US
Mailing Address - Phone:617-939-6323
Mailing Address - Fax:
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:SUITE 90-104
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1929
Practice Address - Country:US
Practice Address - Phone:781-864-2473
Practice Address - Fax:781-536-0016
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1065671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP06352Medicare PIN