Provider Demographics
NPI:1760600175
Name:MOSS, ROCHELLE C (PHD, LPC-S)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:C
Last Name:MOSS
Suffix:
Gender:F
Credentials:PHD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 MEDICAL CENTER DR
Mailing Address - Street 2:#44204
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1658
Mailing Address - Country:US
Mailing Address - Phone:214-385-3314
Mailing Address - Fax:903-886-5780
Practice Address - Street 1:1506 N GREENVILLE AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8622
Practice Address - Country:US
Practice Address - Phone:214-385-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19197101YP2500X
ARP0205021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7014LCOtherBCBSTX PROVIDER NUMBER