Provider Demographics
NPI:1376110569
Name:ROSENBERG, SYDNEY RANCER
Entity Type:Individual
Prefix:MISS
First Name:SYDNEY
Middle Name:RANCER
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SMITH LEVEL RD APT T4
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6557
Mailing Address - Country:US
Mailing Address - Phone:304-860-4188
Mailing Address - Fax:
Practice Address - Street 1:200 N GREENSBORO ST STE D6
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1849
Practice Address - Country:US
Practice Address - Phone:919-381-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCA16898101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health