Individual
MR. ROSSELL LOUIS LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
172 LIBERTY ST, NEWBURGH, NY 12550-4912
(845) 342-5941
Mailing address
172 LIBERTY ST, NEWBURGH, NY 12550-4912
(845) 342-5941
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33454
NY
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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