Provider Demographics
NPI:1093220618
Name:ROSENBERG, ROXANNE (LCMHC, PMH-C)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:LCMHC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102B OAK PARK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3027
Mailing Address - Country:US
Mailing Address - Phone:919-694-7116
Mailing Address - Fax:919-551-7473
Practice Address - Street 1:5102B OAK PARK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3027
Practice Address - Country:US
Practice Address - Phone:919-694-7116
Practice Address - Fax:919-551-7473
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9311101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor