Provider Demographics
NPI:1053958454
Name:LAROSA, LEE ANNE JANNEY (MS, MSC, LPC)
Entity type:Individual
Prefix:
First Name:LEE ANNE
Middle Name:JANNEY
Last Name:LAROSA
Suffix:
Gender:F
Credentials:MS, MSC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ORLANDO AVE
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-1219
Mailing Address - Country:US
Mailing Address - Phone:215-430-2913
Mailing Address - Fax:
Practice Address - Street 1:540 PENNSYLVANIA AVE STE 325
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3311
Practice Address - Country:US
Practice Address - Phone:215-430-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional