Provider Demographics
NPI:1497346423
Name:ROCCA, MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ROCCA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 TROLLEY RD STE E
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8281
Mailing Address - Country:US
Mailing Address - Phone:800-552-4357
Mailing Address - Fax:678-388-9244
Practice Address - Street 1:141 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-2857
Practice Address - Country:US
Practice Address - Phone:678-388-9404
Practice Address - Fax:678-388-9244
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional