Provider Demographics
NPI:1154879484
Name:CROSBY, ROCHENA (LISW-S)
Entity type:Individual
Prefix:
First Name:ROCHENA
Middle Name:
Last Name:CROSBY
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:ROCHENA
Other - Middle Name:
Other - Last Name:CROSBY-HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICDC
Mailing Address - Street 1:2490 LEE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1271
Mailing Address - Country:US
Mailing Address - Phone:216-376-9647
Mailing Address - Fax:
Practice Address - Street 1:2490 LEE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1271
Practice Address - Country:US
Practice Address - Phone:216-376-9647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH131183101YA0400X
OHI.1700038-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)