Provider Demographics
NPI:1942798533
Name:ROSSELL, MARTINE (LMHC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:MARTINE
Middle Name:
Last Name:ROSSELL
Suffix:
Gender:F
Credentials:LMHC, ATR-BC
Other - Prefix:
Other - First Name:MARTINE
Other - Middle Name:
Other - Last Name:COLEPAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1493
Mailing Address - Country:US
Mailing Address - Phone:617-977-5372
Mailing Address - Fax:617-458-8644
Practice Address - Street 1:109 OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1493
Practice Address - Country:US
Practice Address - Phone:617-977-5372
Practice Address - Fax:617-458-8644
Is Sole Proprietor?:No
Enumeration Date:2018-04-29
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10511101YM0800X, 101YM0800X
MA18011246ZA2600X, 246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical