Provider Demographics
NPI:1942502349
Name:ROSSEY, CHRISTOPHER DAVID (LADC LCMHC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:ROSSEY
Suffix:
Gender:M
Credentials:LADC LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1468
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-1468
Mailing Address - Country:US
Mailing Address - Phone:802-223-4156
Mailing Address - Fax:802-223-4332
Practice Address - Street 1:100 HOSPITALITY DRIVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05641
Practice Address - Country:US
Practice Address - Phone:802-223-4156
Practice Address - Fax:802-223-4332
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH884101YA0400X
VT151.0124425101YA0400X
NH777101YM0800X
VT068.0115899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3074628Medicaid