Provider Demographics
NPI:1730732686
Name:DEBRA ROCK COUNSELING LLC
Entity type:Organization
Organization Name:DEBRA ROCK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER DEBRA ROCK COUNSELING LLC
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:928-713-8940
Mailing Address - Street 1:122 N CORTEZ ST STE 305
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3024
Mailing Address - Country:US
Mailing Address - Phone:928-713-8940
Mailing Address - Fax:
Practice Address - Street 1:122 N CORTEZ ST STE 305
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3024
Practice Address - Country:US
Practice Address - Phone:928-713-8940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty