Provider Demographics
NPI:1548057011
Name:RICHARDSON, ROCKO
Entity type:Individual
Prefix:
First Name:ROCKO
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HOLMES BLVD APT H3
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2553
Mailing Address - Country:US
Mailing Address - Phone:504-314-5403
Mailing Address - Fax:
Practice Address - Street 1:2439 MANHATTAN BLVD STE 207
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5361
Practice Address - Country:US
Practice Address - Phone:504-364-8949
Practice Address - Fax:504-364-8968
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health