Provider Demographics
NPI:1083208987
Name:RESILIENCY AND OPTIMISM CHANGES LIVES (R.O.C.) THERAPEUTIC COACHING SE
Entity Type:Organization
Organization Name:RESILIENCY AND OPTIMISM CHANGES LIVES (R.O.C.) THERAPEUTIC COACHING SE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, MBA, MSW
Authorized Official - Phone:617-755-6448
Mailing Address - Street 1:17 RICHMERE RD
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-3201
Mailing Address - Country:US
Mailing Address - Phone:617-755-6448
Mailing Address - Fax:
Practice Address - Street 1:1 WESTINGHOUSE PLZ STE A101
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-2183
Practice Address - Country:US
Practice Address - Phone:617-539-6448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty