Individual
CATHY W ROUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1618
MA
1041C0700X
Clinical Social Worker
Primary
089-0001020
VT
1041C0700X
Clinical Social Worker
1030802
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016766
—
VT
Enumeration date
04/19/2007
Last updated
12/04/2014
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