Healthcare Provider Details

I. General information

NPI: 1073182945
Provider Name (Legal Business Name): DEANNA ROCK LCMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 TIMBER CREST DR
COLUMBIA SC
29229-9211
US

IV. Provider business mailing address

5586 US HIGHWAY 21 S
GLADE VALLEY NC
28627-8912
US

V. Phone/Fax

Practice location:
  • Phone: 803-920-1505
  • Fax:
Mailing address:
  • Phone: 803-920-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8554
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20328
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: