Provider Demographics
NPI:1326832569
Name:ROCH, EMLY (LMSW)
Entity type:Individual
Prefix:
First Name:EMLY
Middle Name:
Last Name:ROCH
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KERENS
Mailing Address - State:TX
Mailing Address - Zip Code:75144-2115
Mailing Address - Country:US
Mailing Address - Phone:972-816-4225
Mailing Address - Fax:
Practice Address - Street 1:704 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:KERENS
Practice Address - State:TX
Practice Address - Zip Code:75144-2115
Practice Address - Country:US
Practice Address - Phone:972-816-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107958104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker