Provider Demographics
NPI:1821072885
Name:ROSSITER, SHERILYN DIANE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:SHERILYN
Middle Name:DIANE
Last Name:ROSSITER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:KNIGHT
Other - Last Name:ROSSITER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:PO BOX 16446
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-6446
Mailing Address - Country:US
Mailing Address - Phone:406-544-6182
Mailing Address - Fax:603-309-0729
Practice Address - Street 1:725 SW HIGGINS AVE STE B
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1420
Practice Address - Country:US
Practice Address - Phone:406-544-6182
Practice Address - Fax:406-258-0676
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT949101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor