Provider Demographics
NPI:1487860003
Name:ROSEN, ELLIOTT J (EDD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:J
Last Name:ROSEN
Suffix:
Gender:M
Credentials:EDD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HARWOOD CT
Mailing Address - Street 2:SUITE 319
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4121
Mailing Address - Country:US
Mailing Address - Phone:914-723-0316
Mailing Address - Fax:914-725-2774
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:SUITE 319
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4121
Practice Address - Country:US
Practice Address - Phone:914-723-0316
Practice Address - Fax:914-725-2774
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00171106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist