Provider Demographics
NPI:1871362574
Name:CHRISTINA L ROCK
Entity type:Organization
Organization Name:CHRISTINA L ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:ROCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, RPT
Authorized Official - Phone:443-610-6151
Mailing Address - Street 1:4358 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5910
Mailing Address - Country:US
Mailing Address - Phone:443-610-6151
Mailing Address - Fax:410-451-1452
Practice Address - Street 1:8280 PATUXENT RANGE RD STE B
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-8606
Practice Address - Country:US
Practice Address - Phone:443-610-6151
Practice Address - Fax:410-451-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)