Provider Demographics
NPI:1477622579
Name:STANLEY ROSNER & BLANCHE A. ROSNER LLC
Entity Type:Organization
Organization Name:STANLEY ROSNER & BLANCHE A. ROSNER LLC
Other - Org Name:COUNSELING & PSYCHOTHERAPY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LLC - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-329-1578
Mailing Address - Street 1:415 SAW MILL RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903
Mailing Address - Country:US
Mailing Address - Phone:203-329-1578
Mailing Address - Fax:203-329-0514
Practice Address - Street 1:415 SAW MILL RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06903
Practice Address - Country:US
Practice Address - Phone:203-329-1578
Practice Address - Fax:203-329-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000115103T00000X
CT001497104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02915Medicare ID - Type Unspecified
R85564Medicare UPIN