Provider Demographics
NPI:1710758016
Name:ROSENBERG, LEIGH AMY (MSW, LGSW)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:AMY
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 RAYMOND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1701
Mailing Address - Country:US
Mailing Address - Phone:612-351-1816
Mailing Address - Fax:
Practice Address - Street 1:970 RAYMOND AVE STE 105
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1701
Practice Address - Country:US
Practice Address - Phone:612-351-1816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN288991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical