Healthcare Provider Details

I. General information

NPI: 1083308308
Provider Name (Legal Business Name): JAVIER OCARIZ M.A. LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 2ND ST SW
ROCHESTER MN
55902-4420
US

IV. Provider business mailing address

5717 STAPLETON LN NW
ROCHESTER MN
55901-3717
US

V. Phone/Fax

Practice location:
  • Phone: 507-216-7995
  • Fax: 507-289-2327
Mailing address:
  • Phone: 541-647-9421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3873
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: