Provider Demographics
NPI:1225680754
Name:OROCK, ERICA (PSYD, NCSP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:OROCK
Suffix:
Gender:F
Credentials:PSYD, NCSP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:SEBASTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, NCSP
Mailing Address - Street 1:23 HARRIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:TRUCKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1703
Mailing Address - Country:US
Mailing Address - Phone:570-574-7383
Mailing Address - Fax:
Practice Address - Street 1:851 COMMERCE BLVD
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1759
Practice Address - Country:US
Practice Address - Phone:570-489-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5842698103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool