Provider Demographics
NPI:1215517925
Name:JAVIER, ROUSSEL (LPC)
Entity type:Individual
Prefix:
First Name:ROUSSEL
Middle Name:
Last Name:JAVIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 HIGHFIELD DR STE C
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-1113
Mailing Address - Country:US
Mailing Address - Phone:484-548-0636
Mailing Address - Fax:
Practice Address - Street 1:3201 HIGHFIELD DR STE C
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1113
Practice Address - Country:US
Practice Address - Phone:484-548-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015325101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional