Provider Demographics
NPI:1538643424
Name:ROHRBAUCK, MARCUS JAMES (LPCC)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:JAMES
Last Name:ROHRBAUCK
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 EARLE BROWN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-4100
Mailing Address - Country:US
Mailing Address - Phone:763-277-1020
Mailing Address - Fax:763-537-7162
Practice Address - Street 1:1312-1314 LIVINGSTON AVENUE
Practice Address - Street 2:
Practice Address - City:WEST ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118
Practice Address - Country:US
Practice Address - Phone:651-457-6999
Practice Address - Fax:651-451-2166
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC018941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical