Provider Demographics
NPI:1356691737
Name:CLAY, ROCHELL DENISE (MA, LPCC)
Entity type:Individual
Prefix:MRS
First Name:ROCHELL
Middle Name:DENISE
Last Name:CLAY
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 BRODIE LN STE 160
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5892
Mailing Address - Country:US
Mailing Address - Phone:505-306-4060
Mailing Address - Fax:
Practice Address - Street 1:750 BROADMOOR BLVD NE STE E
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3442
Practice Address - Country:US
Practice Address - Phone:505-306-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0177271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM19339577Medicaid
NM25709097Medicaid