Provider Demographics
NPI:1841407236
Name:ROSSI, MARTHA HOWE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:HOWE
Last Name:ROSSI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WOODCLIFF TER
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-4208
Mailing Address - Country:US
Mailing Address - Phone:315-263-4692
Mailing Address - Fax:
Practice Address - Street 1:2 WOODCLIFF TER
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-4208
Practice Address - Country:US
Practice Address - Phone:315-263-4692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health