Provider Demographics
NPI:1275092892
Name:ROCK, KIMBRIANNE MONROE (LMHC)
Entity Type:Individual
Prefix:
First Name:KIMBRIANNE
Middle Name:MONROE
Last Name:ROCK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-2406
Mailing Address - Country:US
Mailing Address - Phone:518-301-0050
Mailing Address - Fax:
Practice Address - Street 1:855 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1513
Practice Address - Country:US
Practice Address - Phone:518-434-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009176101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health