Provider Demographics
NPI:1013947613
Name:ROCK, JOSEPH W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:ROCK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20325 CENTER RIDGE RD
Mailing Address - Street 2:628
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3572
Mailing Address - Country:US
Mailing Address - Phone:440-331-5570
Mailing Address - Fax:440-331-3221
Practice Address - Street 1:20325 CENTER RIDGE RD
Practice Address - Street 2:628
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3572
Practice Address - Country:US
Practice Address - Phone:440-331-5570
Practice Address - Fax:440-331-3221
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3325103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHROCP04741Medicare ID - Type Unspecified