Provider Demographics
NPI:1417543711
Name:ROSENBERGER, OLIVIA (LPC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ROSENBERGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W WINONA AVE APT G12
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19074-1413
Mailing Address - Country:US
Mailing Address - Phone:215-622-6594
Mailing Address - Fax:
Practice Address - Street 1:38 HARDING AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1503
Practice Address - Country:US
Practice Address - Phone:215-622-6594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional