Provider Demographics
NPI:1386800811
Name:ROSOLLO COUNSELING LLC
Entity type:Organization
Organization Name:ROSOLLO COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSOLLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:480-206-8295
Mailing Address - Street 1:8414 E SHEA BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6665
Mailing Address - Country:US
Mailing Address - Phone:480-206-8295
Mailing Address - Fax:480-367-1545
Practice Address - Street 1:8414 E SHEA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6665
Practice Address - Country:US
Practice Address - Phone:480-206-8295
Practice Address - Fax:480-367-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW2890251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health