Provider Demographics
NPI:1003180761
Name:PAMELA J ROSENBERG LCSW PLLC
Entity Type:Organization
Organization Name:PAMELA J ROSENBERG LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:919-833-5867
Mailing Address - Street 1:867 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1255
Mailing Address - Country:US
Mailing Address - Phone:919-833-5867
Mailing Address - Fax:919-833-5859
Practice Address - Street 1:867 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1255
Practice Address - Country:US
Practice Address - Phone:919-833-5867
Practice Address - Fax:919-833-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO46361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty