Healthcare Provider Details

I. General information

NPI: 1265217277
Provider Name (Legal Business Name): OCHOCKI COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 FOREST ST
SAINT PAUL MN
55106-1812
US

IV. Provider business mailing address

1431 FOREST ST
SAINT PAUL MN
55106-1812
US

V. Phone/Fax

Practice location:
  • Phone: 651-226-3590
  • Fax:
Mailing address:
  • Phone: 651-226-3590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER OCHOCKI
Title or Position: MA, LPCC
Credential:
Phone: 651-401-7561