Provider Demographics
NPI:1215829213
Name:FIELDS, ROCHELLE PATRICE (BS, IBCLC, DOULA CLC)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:PATRICE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:BS, IBCLC, DOULA CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 HIGHWAY 43 S
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-9273
Mailing Address - Country:US
Mailing Address - Phone:601-540-2605
Mailing Address - Fax:601-540-2605
Practice Address - Street 1:1273 HIGHWAY 43 S
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-9273
Practice Address - Country:US
Practice Address - Phone:601-540-2605
Practice Address - Fax:601-540-2605
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSL-16896101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor