Provider Demographics
NPI:1053810143
Name:ROSELLE, GILYTZA (LMFT)
Entity type:Individual
Prefix:
First Name:GILYTZA
Middle Name:
Last Name:ROSELLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CAMELOT DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-2413
Mailing Address - Country:US
Mailing Address - Phone:203-309-8781
Mailing Address - Fax:
Practice Address - Street 1:58 WINFIELD ST APT A
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06855-2127
Practice Address - Country:US
Practice Address - Phone:203-309-8781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001882101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty