Provider Demographics
NPI:1811224272
Name:ROCK, JESSICA (MA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ROCK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-5428
Mailing Address - Country:US
Mailing Address - Phone:508-849-5640
Mailing Address - Fax:
Practice Address - Street 1:2 GRANITE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-5428
Practice Address - Country:US
Practice Address - Phone:508-849-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor