Provider Demographics
NPI:1235711656
Name:CARRIGAN, ROCKY LEE (LMCSW)
Entity Type:Individual
Prefix:
First Name:ROCKY
Middle Name:LEE
Last Name:CARRIGAN
Suffix:
Gender:M
Credentials:LMCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 E WORKMAN RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:49632-9732
Mailing Address - Country:US
Mailing Address - Phone:231-878-3053
Mailing Address - Fax:
Practice Address - Street 1:3625 E WORKMAN RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MI
Practice Address - Zip Code:49632-9732
Practice Address - Country:US
Practice Address - Phone:231-878-3053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011094841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical