Provider Demographics
NPI:1063025369
Name:ROSENBERG, ANEESAH (LMHC)
Entity Type:Individual
Prefix:
First Name:ANEESAH
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 3RD AVE APT 15J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2625
Mailing Address - Country:US
Mailing Address - Phone:347-607-2770
Mailing Address - Fax:
Practice Address - Street 1:540 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2619
Practice Address - Country:US
Practice Address - Phone:718-875-1167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health