Healthcare Provider Details

I. General information

NPI: 1487821203
Provider Name (Legal Business Name): JEFFREY MICHAEL ROSSMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 EAST RD
WEST STOCKBRIDGE MA
01266-9730
US

IV. Provider business mailing address

247 EAST RD
WEST STOCKBRIDGE MA
01266-9730
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-2146
  • Fax:
Mailing address:
  • Phone: 413-528-2146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4014
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: