Provider Demographics
NPI:1598426645
Name:WOCTCH BEHAVIORAL HEALTH CARE
Entity Type:Organization
Organization Name:WOCTCH BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:ROSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOCTCHOU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:770-906-3430
Mailing Address - Street 1:7902 LOGAN RUN
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2116
Mailing Address - Country:US
Mailing Address - Phone:770-906-3430
Mailing Address - Fax:
Practice Address - Street 1:7902 LOGAN RUN
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-2116
Practice Address - Country:US
Practice Address - Phone:770-906-3430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty