Provider Demographics
NPI:1639358807
Name:ROCHA, KENYA J (LMHC)
Entity type:Individual
Prefix:MS
First Name:KENYA
Middle Name:J
Last Name:ROCHA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KENYA
Other - Middle Name:J
Other - Last Name:RANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:6200 AURORA AVENUE
Mailing Address - Street 2:SUITE 305E
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-2863
Mailing Address - Country:US
Mailing Address - Phone:515-724-8920
Mailing Address - Fax:888-771-3225
Practice Address - Street 1:6200 AURORA AVENUE
Practice Address - Street 2:SUITE 305E
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2863
Practice Address - Country:US
Practice Address - Phone:515-724-8920
Practice Address - Fax:888-771-3225
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health