Provider Demographics
NPI:1619613676
Name:RECOVERY ROCKS COUNSELING LLC
Entity Type:Organization
Organization Name:RECOVERY ROCKS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHONDA
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-CAS C5341214
Authorized Official - Phone:424-237-6085
Mailing Address - Street 1:1618 W 146TH ST UNIT 18A
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-2315
Mailing Address - Country:US
Mailing Address - Phone:424-237-6085
Mailing Address - Fax:
Practice Address - Street 1:1618 W 146TH ST UNIT 18A
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-2315
Practice Address - Country:US
Practice Address - Phone:424-237-6085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health