Provider Demographics
NPI:1063896355
Name:RORVICK, SHELLEY (MA, LMFT)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:RORVICK
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:CAMPBELL-RORVICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:302 W SUPERIOR ST
Mailing Address - Street 2:SUITE 508
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-5115
Mailing Address - Country:US
Mailing Address - Phone:218-409-6456
Mailing Address - Fax:
Practice Address - Street 1:302 W SUPERIOR ST
Practice Address - Street 2:SUITE 508
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-5115
Practice Address - Country:US
Practice Address - Phone:218-727-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16029106H00000X
WI1061-124106H00000X
MN2756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist