Provider Demographics
NPI:1093913923
Name:ROSETO, CINDY (LCSW)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:ROSETO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W 55TH ST
Mailing Address - Street 2:2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4515
Mailing Address - Country:US
Mailing Address - Phone:415-299-0040
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-4864
Practice Address - Country:US
Practice Address - Phone:415-299-0040
Practice Address - Fax:415-299-0040
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05388200103T00000X
NY0794221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY079422OtherNY STATE LICENSE
NJ44SC05376000OtherSTATE LICENSE
NJ44SL05388200OtherSTATE LICENSE