Provider Demographics
NPI:1457084303
Name:ROCK, MEGAN A (PSYD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:ROCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WINDING WAY UNIT L
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1151
Mailing Address - Country:US
Mailing Address - Phone:601-519-9559
Mailing Address - Fax:
Practice Address - Street 1:101 WINDING WAY UNIT L
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-1151
Practice Address - Country:US
Practice Address - Phone:601-519-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TH0004X
OHP.08332103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth