Provider Demographics
NPI:1487042628
Name:ROSENBERG, ALEXANDRA M (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:M
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-2759
Mailing Address - Country:US
Mailing Address - Phone:508-901-1191
Mailing Address - Fax:
Practice Address - Street 1:22 BAILEY RD
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-2759
Practice Address - Country:US
Practice Address - Phone:508-901-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker