Provider Demographics
NPI:1992054993
Name:ROUSE, KRISSA MICHELLE (MA, LCPC)
Entity type:Individual
Prefix:MRS
First Name:KRISSA
Middle Name:MICHELLE
Last Name:ROUSE
Suffix:
Gender:F
Credentials:MA, LCPC
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Mailing Address - Street 1:1137 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4737
Mailing Address - Country:US
Mailing Address - Phone:410-788-6546
Mailing Address - Fax:410-788-2546
Practice Address - Street 1:1137 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-4737
Practice Address - Country:US
Practice Address - Phone:410-979-3961
Practice Address - Fax:410-788-2546
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health