Provider Demographics
NPI:1518088079
Name:ROSENBERG, LAURA BETH (MA LCPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BETH
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 HORATIO BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6416
Mailing Address - Country:US
Mailing Address - Phone:847-361-9147
Mailing Address - Fax:
Practice Address - Street 1:565 LAKEVIEW PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1857
Practice Address - Country:US
Practice Address - Phone:847-793-9800
Practice Address - Fax:847-793-9802
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional