Provider Demographics
NPI:1033192018
Name:ROSENMAN, PHLAXY L (LPC)
Entity Type:Individual
Prefix:MS
First Name:PHLAXY
Middle Name:L
Last Name:ROSENMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 DOE TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4055
Mailing Address - Country:US
Mailing Address - Phone:215-493-3354
Mailing Address - Fax:
Practice Address - Street 1:385 OXFORD VALLEY RD
Practice Address - Street 2:SUITE 312
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7700
Practice Address - Country:US
Practice Address - Phone:215-493-3354
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001861101YP2500X
NJPC01075101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional