Provider Demographics
NPI:1790853612
Name:LACHANCE, ROCHELLE HAYWARD (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:HAYWARD
Last Name:LACHANCE
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:UMANSKY
Other - Last Name:HAYWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWC
Mailing Address - Street 1:8615 RIDGELYS CHOICE DR STE 212
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-529-2151
Mailing Address - Fax:410-529-1342
Practice Address - Street 1:RENEWAL COUNSELING CENTER
Practice Address - Street 2:8615 RIDGELYS CHOICE DR STE 212
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-529-2151
Practice Address - Fax:410-529-1342
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD049081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKL86OtherBLUE CROSS BLUE SHIELD
MDKL860392Medicare ID - Type Unspecified