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General NPI Number Information
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NPI Number | 1467938712
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Entity Type | Organization
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Legal Business Name | LU ROCHA COUNSELING SERVICES PC
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 4071 N BROADWAY ST STE 1
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City | CHICAGO
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State | IL
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Zip | 60613-2117
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Country | US
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Telephone | 773-203-1328
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Fax |
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Provider Business Mailing Address
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Address Line | 4071 N BROADWAY ST STE 1
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City | CHICAGO
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State | IL
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Zip | 60613-2117
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Country | US
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Telephone | 773-203-1328
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Fax |
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Authorized Official
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Title or Position | FOUNDER, PSYCHOTHERAPIST
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Name | LOURDES ROCHA
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Credential | LCSW
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Telephone | 773-217-8571
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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