Provider Demographics
NPI:1225791080
Name:JESSICA ROCHE LMHC LLC
Entity Type:Organization
Organization Name:JESSICA ROCHE LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-450-9625
Mailing Address - Street 1:49 STATE RD
Mailing Address - Street 2:NAUSET BUILDING UNIT 104G
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747
Mailing Address - Country:US
Mailing Address - Phone:401-450-9625
Mailing Address - Fax:
Practice Address - Street 1:49 STATE RD
Practice Address - Street 2:NAUSET BUILDING UNIT 104G
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747
Practice Address - Country:US
Practice Address - Phone:401-450-9625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)