Healthcare Provider Details

I. General information

NPI: 1366507675
Provider Name (Legal Business Name): LORI A ROCKWOOD LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 12/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 S. MADISON
MCGREGOR TX
76657
US

IV. Provider business mailing address

213 S. MADISON
MCGREGOR TX
76657
US

V. Phone/Fax

Practice location:
  • Phone: 254-236-4158
  • Fax: 254-613-5076
Mailing address:
  • Phone: 254-236-4158
  • Fax: 254-774-9672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17415
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: