Provider Demographics
NPI:1487204996
Name:MILENA ROSSIUS LPC
Entity Type:Organization
Organization Name:MILENA ROSSIUS LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MILENA
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:ROSSIUS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:484-800-2798
Mailing Address - Street 1:1001 CITY AVE UNIT ED429
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3908
Mailing Address - Country:US
Mailing Address - Phone:484-800-2798
Mailing Address - Fax:
Practice Address - Street 1:111 PRESIDENTIAL BLVD STE 237
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1012
Practice Address - Country:US
Practice Address - Phone:484-800-2798
Practice Address - Fax:610-664-3749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty