Lee Martin Rousseau, MSW, LBSW, CAADC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802081470 Issued in MI

Practice address

2236 E Mitchell Rd Unit 5
Petoskey, MI 49770-9604

Phone

(231) 347-9880

NPI assigned

Jun 6, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1326530247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 E MITCHELL RD UNIT 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709604",
            "telephone_number": "231-347-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 E MITCHELL RD UNIT 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709604",
            "telephone_number": "231-347-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "LEE",
        "middle_name": "MARTIN",
        "credential": "MSW, LBSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-00022",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802081470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley J Rossman, D.O.
• Shannon Marie Rossman, LBSW, CADC, CPRC
• Donald Bruce Roth, M.D.
• Rebecca Roth, PH.D.
• Mark Rothman, CRNA
• Janelle Routhier, O.D
• Natalia I Rush, M.D.
• Elizabeth Louise Russ, AGACNP
• David Joel Rynbrandt, MD
• Terry J Samuels, M.D.

• Social Worker in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.