Candi Lyn Rosenberg, MA, JD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301018078 Issued in MI

Practice address

595 Forest Ave Ste 7And11A
Plymouth, MI 48170-1775

Phone

(734) 446-5466

NPI assigned

Jan 5, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Juris Doctor, Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578182400000",
    "number": "1861031056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 PILGRIM AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480094804",
            "telephone_number": "248-506-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE STE 7AND11A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701775",
            "telephone_number": "734-446-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 N Haggerty Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481873605",
            "country_code": "US",
            "telephone_number": "734-526-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "CANDI",
        "middle_name": "LYN",
        "credential": "MA, JD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-05",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301018078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Marya Rose
• Darrin Rose
• Kagen Rose
• Kara Rose
• Kristi Lyn Rose, LMSW
• Rosin Associates PLLC
• Jacob C Rosin, M A LLP
• Ross J Hock DDS PC
• Payton Roth
• Alicia M Rothert

• Psychologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.