Provider Demographics
NPI:1649862228
Name:ROCHON, M. CHARLOTTE (LCSW)
Entity type:Individual
Prefix:
First Name:M.
Middle Name:CHARLOTTE
Last Name:ROCHON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CHARLOTTE
Other - Last Name:ROCHON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:230 E 88TH ST APT 8H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3382
Mailing Address - Country:US
Mailing Address - Phone:917-256-9229
Mailing Address - Fax:
Practice Address - Street 1:230 E 88TH ST APT 8H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3382
Practice Address - Country:US
Practice Address - Phone:917-256-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0877491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty