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General NPI Number Information
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NPI Number | 1487388971
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Entity Type | Individual
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Provider Name | SHANNON MARIE ROSSMAN LBSW, CADC, CPRC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 704 EMMET ST
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City | PETOSKEY
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State | MI
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Zip | 49770-2910
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Country | US
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Telephone | 231-347-5511
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Fax | 231-347-5422
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Provider Business Mailing Address
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Address Line | 704 EMMET ST
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City | PETOSKEY
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State | MI
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Zip | 49770-2910
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Country | US
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Telephone | 231-330-0593
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Fax | 313-475-4222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6852091301
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License Number State | MI
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