Provider Demographics
NPI:1275208191
Name:ROCKWALL HEATH COUNSELING, LLC
Entity Type:Organization
Organization Name:ROCKWALL HEATH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CFLE
Authorized Official - Phone:672-961-9570
Mailing Address - Street 1:412 HIGHVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-8245
Mailing Address - Country:US
Mailing Address - Phone:972-834-9322
Mailing Address - Fax:
Practice Address - Street 1:6780 HORIZON RD STE 100
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-2104
Practice Address - Country:US
Practice Address - Phone:972-961-9571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty