Provider Demographics
NPI:1083599971
Name:ROSENOW, GAGE JAMES KENNEDY (LCPC-C)
Entity type:Individual
Prefix:MR
First Name:GAGE
Middle Name:JAMES KENNEDY
Last Name:ROSENOW
Suffix:
Gender:M
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LEAVITT ST
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-1843
Mailing Address - Country:US
Mailing Address - Phone:207-458-4642
Mailing Address - Fax:844-331-2315
Practice Address - Street 1:30 LEAVITT ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1843
Practice Address - Country:US
Practice Address - Phone:207-458-4642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL8268101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor