Provider Demographics
NPI:1629209556
Name:LEE ROCHA, NICOLE E
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:E
Last Name:LEE ROCHA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:E
Other - Last Name:LEE ROCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:14 MYLES RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-6645
Mailing Address - Country:US
Mailing Address - Phone:978-335-8811
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 207P
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6104
Practice Address - Country:US
Practice Address - Phone:978-338-6212
Practice Address - Fax:978-268-5777
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)