Provider Demographics
NPI:1326332867
Name:ROSENBERG, ELAINE L (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:L
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E DOTY ST STE 507
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3397
Mailing Address - Country:US
Mailing Address - Phone:805-699-5615
Mailing Address - Fax:608-251-3930
Practice Address - Street 1:10 E DOTY ST STE 507
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3397
Practice Address - Country:US
Practice Address - Phone:805-699-5615
Practice Address - Fax:608-251-3930
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80617106H00000X
WI1077-124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist