Provider Demographics
NPI:1053996322
Name:SPINELLA, ROSALIE ANNE (LADC , CADC)
Entity type:Individual
Prefix:
First Name:ROSALIE
Middle Name:ANNE
Last Name:SPINELLA
Suffix:
Gender:F
Credentials:LADC , CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2730
Mailing Address - Country:US
Mailing Address - Phone:860-631-7303
Mailing Address - Fax:
Practice Address - Street 1:1138 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2730
Practice Address - Country:US
Practice Address - Phone:860-631-7303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001390101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)