Provider Demographics
NPI:1427094580
Name:ROCHE, CHERYL LYNN (MSW LCSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:ROCHE
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 1410
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3527
Mailing Address - Country:US
Mailing Address - Phone:504-833-1442
Mailing Address - Fax:504-834-3101
Practice Address - Street 1:3500 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 1410
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3527
Practice Address - Country:US
Practice Address - Phone:504-833-1442
Practice Address - Fax:504-834-3101
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1790104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S309Medicare ID - Type Unspecified