Provider Demographics
NPI:1932110756
Name:KELLY, CINDI ROSNER (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CINDI
Middle Name:ROSNER
Last Name:KELLY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3011 W GRAND BLVD
Mailing Address - Street 2:27172 WOODWARD #200
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067
Mailing Address - Country:US
Mailing Address - Phone:313-872-6336
Mailing Address - Fax:
Practice Address - Street 1:CR PSYCHOTHERAPY SERVICES LLC
Practice Address - Street 2:21800 HAGGEITY RD #220
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167
Practice Address - Country:US
Practice Address - Phone:734-887-1785
Practice Address - Fax:866-422-3133
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801061175104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker