Provider Demographics
NPI:1467252874
Name:MAROCCO, VINCENT ROGER (MSW)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:ROGER
Last Name:MAROCCO
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 N ASHLAND AVE APT 2S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3081
Mailing Address - Country:US
Mailing Address - Phone:206-437-3970
Mailing Address - Fax:
Practice Address - Street 1:840 W IRVING PARK RD STE 302&304
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3011
Practice Address - Country:US
Practice Address - Phone:253-693-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker