Provider Demographics
NPI:1063692275
Name:DENNIS ROCKWELL INC
Entity type:Organization
Organization Name:DENNIS ROCKWELL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ROCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-477-5836
Mailing Address - Street 1:FONTANA PLAZA, 9045 LAFONTANA BLVD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5636
Mailing Address - Country:US
Mailing Address - Phone:561-477-5836
Mailing Address - Fax:561-477-7388
Practice Address - Street 1:FONTANA PLAZA, 9045 LAFONTANA BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5636
Practice Address - Country:US
Practice Address - Phone:561-477-5836
Practice Address - Fax:561-477-7388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW0004553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6892OtherBLUE CROSS/BLUE SHIELD
FL6281531OtherUNITED BEHAVIORAL HEALTH
FL6281531OtherUNITED BEHAVIORAL HEALTH