Provider Demographics
NPI:1386953164
Name:NIGHTENGALE, ROCHELLE M (MS, LPC, CRC)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:M
Last Name:NIGHTENGALE
Suffix:
Gender:F
Credentials:MS, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27872
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23261-7872
Mailing Address - Country:US
Mailing Address - Phone:804-337-3277
Mailing Address - Fax:
Practice Address - Street 1:3122 W MARSHALL ST STE 215
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4734
Practice Address - Country:US
Practice Address - Phone:804-337-3277
Practice Address - Fax:804-249-4127
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004858101YP2500X
VA00051953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health