Provider Demographics
NPI:1144297276
Name:DESROSIERS, LANI E (LMHC)
Entity type:Individual
Prefix:MS
First Name:LANI
Middle Name:E
Last Name:DESROSIERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WYANDOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10928-1311
Mailing Address - Country:US
Mailing Address - Phone:845-446-0600
Mailing Address - Fax:
Practice Address - Street 1:15 WYANDOTTE AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND FALLS
Practice Address - State:NY
Practice Address - Zip Code:10928-1311
Practice Address - Country:US
Practice Address - Phone:845-446-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-000869101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor