Provider Demographics
NPI:1053613182
Name:ROSECRANS, JAMES (LMHC, LICDC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ROSECRANS
Suffix:
Gender:M
Credentials:LMHC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1333
Mailing Address - Country:US
Mailing Address - Phone:440-963-0402
Mailing Address - Fax:440-963-4018
Practice Address - Street 1:5475 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-1333
Practice Address - Country:US
Practice Address - Phone:440-963-0402
Practice Address - Fax:440-963-4018
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH964539101YA0400X
FLMH0003050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health