Provider Demographics
NPI:1194529560
Name:ROSANSKY, LEXI JADE
Entity type:Individual
Prefix:
First Name:LEXI
Middle Name:JADE
Last Name:ROSANSKY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 WATERCHASE WAY SW APT 212
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-5948
Mailing Address - Country:US
Mailing Address - Phone:517-442-1245
Mailing Address - Fax:
Practice Address - Street 1:3800 LAKE MICHIGAN DR NW STE 103
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534-4583
Practice Address - Country:US
Practice Address - Phone:616-499-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical