Provider Demographics
NPI:1760685002
Name:ROSENBAUM, LILIAN (LCSW C PHD)
Entity Type:Individual
Prefix:DR
First Name:LILIAN
Middle Name:
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:LCSW C PHD
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:LILIAN
Other - Last Name:ROSENBAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:180 NEW MARK ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2732
Mailing Address - Country:US
Mailing Address - Phone:301-907-9664
Mailing Address - Fax:301-340-8958
Practice Address - Street 1:6935 WISCONSIN AVE
Practice Address - Street 2:SUITE #206
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6109
Practice Address - Country:US
Practice Address - Phone:301-907-9664
Practice Address - Fax:301-340-8958
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3010921041C0700X
MD004651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
646447Medicare ID - Type Unspecified