Provider Demographics
NPI:1275846172
Name:ROCK, SARAH MARIE (LPC, MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:ROCK
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60312
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79711-0312
Mailing Address - Country:US
Mailing Address - Phone:432-563-4144
Mailing Address - Fax:432-561-8611
Practice Address - Street 1:10008 PILOT AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-2615
Practice Address - Country:US
Practice Address - Phone:432-563-4144
Practice Address - Fax:432-561-8611
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63534101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional