Provider Demographics
NPI:1275817272
Name:ROSENDALE, ROBIN JAMES (LMHC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:JAMES
Last Name:ROSENDALE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 WEST 18TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4462
Mailing Address - Country:US
Mailing Address - Phone:646-588-1387
Mailing Address - Fax:
Practice Address - Street 1:356 WEST 18TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4462
Practice Address - Country:US
Practice Address - Phone:646-588-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004671-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health