Healthcare Provider Details

I. General information

NPI: 1346104833
Provider Name (Legal Business Name): TIMOTHY ROCK LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7398 SPINNAKER BLVD
ENGLEWOOD FL
34224-8251
US

IV. Provider business mailing address

7398 SPINNAKER BLVD
ENGLEWOOD FL
34224-8251
US

V. Phone/Fax

Practice location:
  • Phone: 518-373-8261
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: