Provider Demographics
NPI:1366507675
Name:ROCKWOOD, LORI A (LPC-S)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:ROCKWOOD
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S. MADISON
Mailing Address - Street 2:
Mailing Address - City:MCGREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657
Mailing Address - Country:US
Mailing Address - Phone:254-236-4158
Mailing Address - Fax:254-774-9672
Practice Address - Street 1:213 S. MADISON
Practice Address - Street 2:
Practice Address - City:MCGREGOR
Practice Address - State:TX
Practice Address - Zip Code:76657
Practice Address - Country:US
Practice Address - Phone:254-236-4158
Practice Address - Fax:254-613-5076
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17415101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85139LOtherBCBS OF TEXAS PROVIDER #
TX181823901Medicaid