Basic Information
| Provider Information | |||||||||
| NPI: | 1225574163 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROHRICH | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | |||||||||
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| Credential: | LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1237 W DIVIDE AVE | ||||||||
| Address2: | STE 5 | ||||||||
| City: | BISMARCK | ||||||||
| State: | ND | ||||||||
| PostalCode: | 585011220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013288873 | ||||||||
| FaxNumber: | 7013288900 | ||||||||
| Practice Location | |||||||||
| Address1: | 1237 W DIVIDE AVE | ||||||||
| Address2: | STE 5 | ||||||||
| City: | BISMARCK | ||||||||
| State: | ND | ||||||||
| PostalCode: | 585011220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013288873 | ||||||||
| FaxNumber: | 7013288900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2017 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 1722 | ND | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.