Provider Demographics
NPI:1194082826
Name:ROCKHILL, PENNEY ANN (LCPC)
Entity type:Individual
Prefix:
First Name:PENNEY
Middle Name:ANN
Last Name:ROCKHILL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 E 17TH ST STE 190
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6518
Mailing Address - Country:US
Mailing Address - Phone:208-419-6102
Mailing Address - Fax:208-542-8004
Practice Address - Street 1:1820 E 17TH ST STE 190
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6518
Practice Address - Country:US
Practice Address - Phone:208-419-6102
Practice Address - Fax:208-542-8004
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID4549101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health