Provider Demographics
NPI:1972884252
Name:ROCKWOOD, MEGAN RAE (MA, LMHC, CAP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RAE
Last Name:ROCKWOOD
Suffix:
Gender:F
Credentials:MA, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10175 FORTUNE PKWY
Mailing Address - Street 2:ST 1106
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6746
Mailing Address - Country:US
Mailing Address - Phone:904-379-5928
Mailing Address - Fax:888-793-2304
Practice Address - Street 1:10175 FORTUNE PKWY
Practice Address - Street 2:ST 1106
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6746
Practice Address - Country:US
Practice Address - Phone:904-379-5928
Practice Address - Fax:888-793-2304
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002283A101YM0800X
FLMH11413101YM0800X
FLCAP 5818101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009662900Medicaid