Provider Demographics
NPI:1801953617
Name:O'ROURKE, CHARLES FRANCIS (LPC)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:FRANCIS
Last Name:O'ROURKE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E HANOVER AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-2020
Mailing Address - Country:US
Mailing Address - Phone:973-401-2121
Mailing Address - Fax:973-401-2140
Practice Address - Street 1:100 E HANOVER AVE
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2020
Practice Address - Country:US
Practice Address - Phone:973-401-2121
Practice Address - Fax:973-401-2140
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00096400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health