Provider Demographics
NPI:1710166434
Name:ROSENBERG, HAROLD JAY (MSSW , LICSW)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:JAY
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MSSW , LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818 BIG SKY DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3524
Mailing Address - Country:US
Mailing Address - Phone:608-833-4990
Mailing Address - Fax:608-826-9019
Practice Address - Street 1:7818 BIG SKY DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3524
Practice Address - Country:US
Practice Address - Phone:608-833-4990
Practice Address - Fax:608-826-9019
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical