Provider Demographics
NPI:1184761124
Name:ROSEN, BARBARA LYN (PHD,LCSW)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LYN
Last Name:ROSEN
Suffix:
Gender:F
Credentials:PHD,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1306
Mailing Address - Country:US
Mailing Address - Phone:860-233-4023
Mailing Address - Fax:860-236-4116
Practice Address - Street 1:682 PROSPECT AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4238
Practice Address - Country:US
Practice Address - Phone:860-236-4116
Practice Address - Fax:860-236-4116
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0048991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical