Provider Demographics
NPI:1043381643
Name:HAL ROSENBERG LTD
Entity Type:Organization
Organization Name:HAL ROSENBERG LTD
Other - Org Name:MIDWEST ASSOCIATED PSYCHOTHERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW,MSSW,MASC,ACSW
Authorized Official - Phone:608-833-4990
Mailing Address - Street 1:7818 BIG SKY DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3524
Mailing Address - Country:US
Mailing Address - Phone:608-833-4990
Mailing Address - Fax:608-826-9019
Practice Address - Street 1:7818 BIG SKY DR
Practice Address - Street 2:SUITE 207
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3524
Practice Address - Country:US
Practice Address - Phone:608-833-4990
Practice Address - Fax:608-826-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42217800Medicaid
WI44405Medicare ID - Type Unspecified