Provider Demographics
NPI:1689479099
Name:ROSENLIEB, CASEY ALYNN (SA COUNSELOR)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:ALYNN
Last Name:ROSENLIEB
Suffix:
Gender:
Credentials:SA COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 16TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-1423
Mailing Address - Country:US
Mailing Address - Phone:805-234-8915
Mailing Address - Fax:
Practice Address - Street 1:1361 16TH ST
Practice Address - Street 2:
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-1423
Practice Address - Country:US
Practice Address - Phone:805-234-8915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB9708652101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)