Provider Demographics
NPI:1033688403
Name:ROLLOCKS, JAMARRI M (CAADC, MATS, LPC)
Entity type:Individual
Prefix:
First Name:JAMARRI
Middle Name:M
Last Name:ROLLOCKS
Suffix:
Gender:F
Credentials:CAADC, MATS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PRICE PL STE 208
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3262
Mailing Address - Country:US
Mailing Address - Phone:608-571-3866
Mailing Address - Fax:
Practice Address - Street 1:313 PRICE PL STE 208
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3262
Practice Address - Country:US
Practice Address - Phone:608-571-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAC0261101YA0400X
GALPC012067101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty