Provider Demographics
NPI:1770074320
Name:ROCCHIO, ROBERT A JR (MSW, LICSW, CGS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:ROCCHIO
Suffix:JR
Gender:M
Credentials:MSW, LICSW, CGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GRAY COACH W
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-3452
Mailing Address - Country:US
Mailing Address - Phone:401-699-2881
Mailing Address - Fax:
Practice Address - Street 1:8 GRAY COACH W
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02921-3452
Practice Address - Country:US
Practice Address - Phone:401-699-2881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW009281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical