Provider Demographics
NPI:1821013806
Name:ROSEN, DANIEL T (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:T
Last Name:ROSEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 PANORAMA TRL STE 2220
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2431
Mailing Address - Country:US
Mailing Address - Phone:585-865-3584
Mailing Address - Fax:877-992-6905
Practice Address - Street 1:625 PANORAMA TRL STE 2220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2431
Practice Address - Country:US
Practice Address - Phone:585-865-3584
Practice Address - Fax:877-992-6905
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0451261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical