DR. MARY R. ROSENBERG (NPI# 1841405867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1841405867 |
Entity Type | Individual |
Full Name | DR. MARY R. ROSENBERG |
Credential | PH.D. |
Practice Address |
604 E College St Carbondale IL 62901-3309 |
Practice Telephone | 6184576703 |
Mailing Telephone | 6184576703 |
Enumeration Date | 2007-05-12 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLUE CROSS & BLUE SHIELD | 0023940229 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689650483 | Mary K. Rosenberg | Registered Nurse | 9855 Hospital Dr Ste 275, Maple Grove, MN 55369-4778 | 2005-12-22 |
1730212275 | Mary Leon Rosenberg | Psychologist | 14340 Torrey Chase Blvd, Suite 160, Houston, TX 77014-1021 | 2007-03-13 |
1528162807 | Mary Klemer Rosenberg | Physical Therapist | 7080 Hollywood Blvd, Suite 815, Los Angeles, CA 90028 | 2006-09-08 |
Street Address |
604 E COLLEGE ST |
City | CARBONDALE |
State | IL |
Zip Code | 62901-3309 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932251758 | Southern Illinois Regional Social Services | Community/Behavioral Health | 604 E College St, Carbondale, IL 62901-3309 | 2007-01-18 |
1932475506 | Southern Il Regional Social Services | Community/Behavioral Health | 604 E College St, Carbondale, IL 62901-3309 | 2012-03-28 |
1174897433 | The H Group Bbt, Inc | Community/Behavioral Health | 604 E College St, Carbondale, IL 62901-3309 | 2012-03-05 |
1326326877 | Daniel Wynn Balchen | Case Manager/Care Coordinator | 604 E College St, Carbondale, IL 62901-3309 | 2011-08-02 |
1669768446 | Geri L Tucker | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2011-06-21 |
1366737967 | Verletta Saxon | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2011-06-13 |
1073808796 | Tamara Marie George | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2011-06-10 |
1366745598 | Susan L Irwin | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2010-12-09 |
1144522889 | Rachelle Erin Ridgeway | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2010-12-01 |
1558692285 | Michelle Lynn Gibbs | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2010-01-20 |
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1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
Find all providers in zip 62901 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306196761 | Jean A. Cunningham | Psychologist | 231 W Main St Ste 1, Carbondale, IL 62901-2948 | 2012-09-13 |
1144479478 | Holly Cormier | Psychologist | 139 Pine Shore Dr, 37, Carbondale, IL 62902-7503 | 2008-09-10 |
1770795882 | Lori Anne Hinsley | Psychologist | Student Health Center, 374 E Grand, Carbondale, IL 62901 | 2007-05-03 |
1417173782 | Debra Lynn Braunling Mcmorrow | Psychologist | 306 W Mill Street, 2nd Floor, Carbondale, IL 62902 | 2007-04-17 |
1376661272 | James S Peterson | Psychologist | 1400 W Main, Suite 16, Carbondale, IL 62901 | 2007-03-27 |
1437247012 | Melinda Luanne Bloos | Psychologist | 3200 Fishback Rd, Milwood Executive Suites, Carbondale, IL 62901-6307 | 2006-10-10 |
1093740862 | Jeffrey Saunders Kellogg | Psychologist | 3412 S Illinois Ave, Carbondale, IL 62903-8362 | 2006-07-11 |
1134748635 | Warren Thomas Bush | Psychologist | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2020-04-14 |
1700412871 | Jose Arroyo | Psychologist | 231 W Main St Ste 1, Carbondale, IL 62901-2948 | 2020-03-20 |
1992210975 | Alec Eshelman | Psychologist | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2017-12-12 |
Find all providers in CARBONDALE |
City | CARBONDALE |
Zip Code | 62901 |
Please comment or provide details below to improve the information on DR. MARY R. ROSENBERG.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.