Provider Demographics
NPI:1700614047
Name:SULLIVAN, ROCHELLE PAM (LGPC)
Entity type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:PAM
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 ADVISORY CT
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6681
Mailing Address - Country:US
Mailing Address - Phone:301-325-8191
Mailing Address - Fax:
Practice Address - Street 1:2 RESERVOIR CIR STE 100
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6395
Practice Address - Country:US
Practice Address - Phone:410-929-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional