Provider Demographics
NPI:1508079211
Name:ROCKNE, JANA L (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:L
Last Name:ROCKNE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 CASS ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2507
Mailing Address - Country:US
Mailing Address - Phone:231-935-4662
Mailing Address - Fax:231-935-4648
Practice Address - Street 1:216 CASS ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2507
Practice Address - Country:US
Practice Address - Phone:231-935-4662
Practice Address - Fax:231-935-4648
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007912101Y00000X
MI4101006197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist