Provider Demographics
NPI:1770732778
Name:ROSKY, MICHELLE (MSED, LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ROSKY
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:DEFORREST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 NEW SALEM RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8936
Mailing Address - Country:US
Mailing Address - Phone:724-438-3576
Mailing Address - Fax:724-438-3305
Practice Address - Street 1:100 NEW SALEM RD
Practice Address - Street 2:SUITE 106
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8936
Practice Address - Country:US
Practice Address - Phone:724-438-3576
Practice Address - Fax:724-438-3305
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004780101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC004780OtherLICENSED PROFESSIONAL COUNSELOR