Provider Demographics
NPI:1588953053
Name:ROSSIGNOL, SCOTT (LPC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:ROSSIGNOL
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 1:1177 SILAS DEANE HWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4348
Mailing Address - Country:US
Mailing Address - Phone:860-571-0580
Mailing Address - Fax:
Practice Address - Street 1:35 FOX HILL RD
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4127
Practice Address - Country:US
Practice Address - Phone:860-202-7644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional