Provider Demographics
NPI:1467938712
Name:LU ROCHA COUNSELING SERVICES PC
Entity Type:Organization
Organization Name:LU ROCHA COUNSELING SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-217-8571
Mailing Address - Street 1:4071 N BROADWAY ST STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2117
Mailing Address - Country:US
Mailing Address - Phone:773-203-1328
Mailing Address - Fax:
Practice Address - Street 1:4071 N BROADWAY ST STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2117
Practice Address - Country:US
Practice Address - Phone:773-203-1328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty