Provider Demographics
NPI:1003314824
Name:ROCHELLE-CATOE, TANIA VAN (MS LPC NCC)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:VAN
Last Name:ROCHELLE-CATOE
Suffix:
Gender:F
Credentials:MS LPC NCC
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:VAN
Other - Last Name:ROCHELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1292 OCTAVIA CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-4914
Mailing Address - Country:US
Mailing Address - Phone:404-384-6154
Mailing Address - Fax:
Practice Address - Street 1:376 POWDER SPRINGS ST STE 240A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3499
Practice Address - Country:US
Practice Address - Phone:678-444-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional