Provider Demographics
NPI:1639653728
Name:ROSENSHINE, ANDREW (LICSW)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ROSENSHINE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ONEIL DR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3008
Mailing Address - Country:US
Mailing Address - Phone:508-667-7222
Mailing Address - Fax:
Practice Address - Street 1:16 ONEIL DR
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3008
Practice Address - Country:US
Practice Address - Phone:508-667-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0001215001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical