Provider Demographics
NPI:1396029682
Name:LAROCK, KATIE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:LAROCK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 W DOMINICK ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-5855
Mailing Address - Country:US
Mailing Address - Phone:315-272-2748
Mailing Address - Fax:315-272-2740
Practice Address - Street 1:199 W DOMINICK ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5855
Practice Address - Country:US
Practice Address - Phone:315-272-2748
Practice Address - Fax:315-272-2740
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY088935-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker