Provider Demographics
NPI:1437798998
Name:ROCKSTAD, DENAYA LOU-JEAN (LPCC)
Entity Type:Individual
Prefix:
First Name:DENAYA
Middle Name:LOU-JEAN
Last Name:ROCKSTAD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:DENAYA
Other - Middle Name:LOU-JEAN ROCKSTAD
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NA
Mailing Address - Street 1:2589 HAMLINE AVE N STE C
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3185
Mailing Address - Country:US
Mailing Address - Phone:651-330-6205
Mailing Address - Fax:651-330-8718
Practice Address - Street 1:2589 HAMLINE AVE N STE C
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3185
Practice Address - Country:US
Practice Address - Phone:651-330-6205
Practice Address - Fax:651-330-8718
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02315101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional