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General NPI Number Information
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NPI Number | 1932778602
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Entity Type | Individual
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Provider Name | MARK ROSSELI PSYD, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 10/22/2022
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Provider Practice Location Address
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Address Line | 2375 NE 25TH AVE STE 106
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City | OCALA
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State | FL
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Zip | 34470-3973
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Country | US
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Telephone | 352-350-1619
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Fax |
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Provider Business Mailing Address
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Address Line | 2375 NE 25TH AVE STE 106
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City | OCALA
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State | FL
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Zip | 34470-3973
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Country | US
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Telephone | 352-350-1619
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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Taxonomy #3
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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Taxonomy #4
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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Taxonomy #5
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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Taxonomy #6
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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Taxonomy #7
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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Taxonomy #8
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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Taxonomy #9
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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Taxonomy #11
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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Taxonomy #12
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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Taxonomy #13
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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