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General NPI Number Information
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NPI Number | 1942869813
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Entity Type | Individual
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Provider Name | MARY ELIZABETH JOHNSON ROCKERS MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 822 BROAD ST
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City | DURHAM
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State | NC
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Zip | 27705-4138
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Country | US
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Telephone | 919-205-9491
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 ROSEHILL AVE
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City | DURHAM
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State | NC
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Zip | 27705-4018
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Country | US
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Telephone | 919-265-3422
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P013564
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License Number State | NC
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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 | C014710
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License Number State | NC
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