Healthcare Provider Details

I. General information

NPI: 1013445550
Provider Name (Legal Business Name): CHRISTOPHER CHARLES COSMO ROCCHIO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2017
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 WIND CHIME CT
RALEIGH NC
27615-6433
US

IV. Provider business mailing address

1128 COPPER BEECH LN
WAKE FOREST NC
27587-3365
US

V. Phone/Fax

Practice location:
  • Phone: 808-679-9876
  • Fax:
Mailing address:
  • Phone: 984-267-4731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018478
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3803
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: