Provider Demographics
NPI:1851305213
Name:ROSENBAUM, CINDY MARTHA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:MARTHA
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 OLD KINGS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653
Mailing Address - Country:US
Mailing Address - Phone:508-240-3445
Mailing Address - Fax:508-487-0501
Practice Address - Street 1:165 OLD KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653
Practice Address - Country:US
Practice Address - Phone:508-240-3445
Practice Address - Fax:508-487-0501
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10154381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1015432OtherTUFTS HEALTH PLAN
MA1015432OtherTUFTS HEALTH PLAN