Healthcare Provider Details

I. General information

NPI: 1417939406
Provider Name (Legal Business Name): ROCKINGHAM CHILDREN & FAMILY COUNSELING, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 05/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 E GREEN ST
ROCKINGHAM NC
28379-3423
US

IV. Provider business mailing address

304 E GREEN ST
ROCKINGHAM NC
28379-3423
US

V. Phone/Fax

Practice location:
  • Phone: 910-999-9999
  • Fax:
Mailing address:
  • Phone: 910-997-4700
  • Fax: 801-409-9045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004437
License Number StateNC

VIII. Authorized Official

Name: JONADAB S FRANCO
Title or Position: PRESIDENT / CLINICAL DIRECTOR
Credential: MSW, LCSW, QCSW
Phone: 910-997-4700