Provider Demographics
NPI:1679867055
Name:ROSENCRANTZ, ELANA (PSYD)
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:
Last Name:ROSENCRANTZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2843
Mailing Address - Country:US
Mailing Address - Phone:206-313-6795
Mailing Address - Fax:
Practice Address - Street 1:1812 E MADISON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2843
Practice Address - Country:US
Practice Address - Phone:206-313-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60215201101YM0800X
WAPY60271806103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health