Provider Demographics
NPI:1700010428
Name:ROCHE, JONI L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:L
Last Name:ROCHE
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 1:4525 EDGEDALE WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2329
Mailing Address - Country:US
Mailing Address - Phone:719-339-8097
Mailing Address - Fax:719-282-0862
Practice Address - Street 1:4525 EDGEDALE WAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-2329
Practice Address - Country:US
Practice Address - Phone:719-339-8097
Practice Address - Fax:719-282-0862
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-09
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health