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General NPI Number Information
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NPI Number | 1083308308
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Entity Type | Individual
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Provider Name | JAVIER OCARIZ M.A. LPCC
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Gender | Male
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 2212 2ND ST SW
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City | ROCHESTER
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State | MN
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Zip | 55902-4420
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Country | US
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Telephone | 507-216-7995
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Fax | 507-289-2327
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Provider Business Mailing Address
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Address Line | 5717 STAPLETON LN NW
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City | ROCHESTER
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State | MN
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Zip | 55901-3717
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Country | US
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Telephone | 541-647-9421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3873
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License Number State | MN
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