Provider Demographics
NPI:1184147613
Name:ROUSSEAU, AARON PAUL (LPC)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:PAUL
Last Name:ROUSSEAU
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 1ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2738
Mailing Address - Country:US
Mailing Address - Phone:541-231-8907
Mailing Address - Fax:541-981-5047
Practice Address - Street 1:340 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2738
Practice Address - Country:US
Practice Address - Phone:541-231-8907
Practice Address - Fax:541-981-5047
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC3751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional