Provider Demographics
NPI:1093252090
Name:ROSENKRANTZ, MIRANDA E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:E
Last Name:ROSENKRANTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MIRANDA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:470 MAIN ST STE 312
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4516
Mailing Address - Country:US
Mailing Address - Phone:860-930-7270
Mailing Address - Fax:
Practice Address - Street 1:470 MAIN ST STE 312
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4516
Practice Address - Country:US
Practice Address - Phone:860-930-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT97031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical