Provider Demographics
NPI:1033655832
Name:ROSSMAN, JODI
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:ROSSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 UNION STREET
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-374-6263
Mailing Address - Fax:518-374-1778
Practice Address - Street 1:1311 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2905
Practice Address - Country:US
Practice Address - Phone:518-374-6263
Practice Address - Fax:518-374-1778
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health