Provider Demographics
NPI:1366678062
Name:ROSADO, JESSICA LYNN KULIG (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN KULIG
Last Name:ROSADO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:KULIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1153 CENTRE STREET
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:508-369-0273
Mailing Address - Fax:
Practice Address - Street 1:1153 CENTRE STREET
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:508-872-3333
Practice Address - Fax:508-875-2600
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA7685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health