Provider Demographics
NPI:1275719239
Name:ROCKEY, STEFANIE A (BSW, LISW)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:A
Last Name:ROCKEY
Suffix:
Gender:F
Credentials:BSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22251 STATE ROUTE 2
Mailing Address - Street 2:
Mailing Address - City:ARCHBOLD
Mailing Address - State:OH
Mailing Address - Zip Code:43502-9452
Mailing Address - Country:US
Mailing Address - Phone:419-445-1552
Mailing Address - Fax:419-445-1401
Practice Address - Street 1:108 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1603
Practice Address - Country:US
Practice Address - Phone:419-636-1713
Practice Address - Fax:419-445-1401
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0030715104100000X
OHI11010171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker