Provider Demographics
NPI:1770747636
Name:ROCKWELL, INC.
Entity type:Organization
Organization Name:ROCKWELL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISCENSED PSYCHOLOGICAL ASSOCIATE
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROCKWELL FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPA
Authorized Official - Phone:919-259-0756
Mailing Address - Street 1:2304 HALES RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1446
Mailing Address - Country:US
Mailing Address - Phone:919-259-0756
Mailing Address - Fax:
Practice Address - Street 1:3721 BENSON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7324
Practice Address - Country:US
Practice Address - Phone:919-259-0756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1472302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization