Provider Demographics
NPI:1518248186
Name:CORNWALL, ROCHELLE JAMILLE (LCSW)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:JAMILLE
Last Name:CORNWALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:JAMILLE CORNWALL
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6030 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5137
Mailing Address - Country:US
Mailing Address - Phone:954-534-5219
Mailing Address - Fax:
Practice Address - Street 1:6030 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5137
Practice Address - Country:US
Practice Address - Phone:954-534-5219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW166631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty