Healthcare Provider Details

I. General information

NPI: 1972856797
Provider Name (Legal Business Name): ERIN JEAN ROCCO MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN JEAN OTIZ

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 BROADMOOR VALLEY RD STE 102
COLORADO SPRINGS CO
80906-4466
US

IV. Provider business mailing address

5345 JARMAN ST
COLORADO SPRINGS CO
80906-7957
US

V. Phone/Fax

Practice location:
  • Phone: 719-470-1065
  • Fax:
Mailing address:
  • Phone: 719-233-6894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0012669
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLPC.0012669
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: