Provider Demographics
NPI:1891248357
Name:ROCK, CHRISTINA (LPC, LSATP, CSAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ROCK
Suffix:
Gender:F
Credentials:LPC, LSATP, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17932 FRALEY BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2456
Mailing Address - Country:US
Mailing Address - Phone:571-636-1800
Mailing Address - Fax:571-636-1900
Practice Address - Street 1:17932 FRALEY BLVD STE 240
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2456
Practice Address - Country:US
Practice Address - Phone:571-636-1800
Practice Address - Fax:571-636-1900
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009120-1101YP2500X
VA0701008028101YP2500X
VA0710103071101YA0400X
VA0718000412101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty