Provider Demographics
NPI:1740353655
Name:JOCZ, DAVID (LPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JOCZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CENTERPOINTE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8651
Mailing Address - Country:US
Mailing Address - Phone:503-853-4204
Mailing Address - Fax:
Practice Address - Street 1:5 CENTERPOINTE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8651
Practice Address - Country:US
Practice Address - Phone:503-853-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional