Provider Demographics
NPI:1396367223
Name:ROSSIGNOL, JOEY (LMHC)
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:
Last Name:ROSSIGNOL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-5207
Mailing Address - Country:US
Mailing Address - Phone:617-435-1987
Mailing Address - Fax:
Practice Address - Street 1:142 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-5207
Practice Address - Country:US
Practice Address - Phone:617-435-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9996101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health