Provider Demographics
NPI:1265798748
Name:BLAS, ROCIO (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROCIO
Middle Name:
Last Name:BLAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ROCIO
Other - Middle Name:
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:719 FIELDCREST DR
Mailing Address - Street 2:#B
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3097
Mailing Address - Country:US
Mailing Address - Phone:847-873-9201
Mailing Address - Fax:
Practice Address - Street 1:1970 LARKIN AVE STE 5
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5891
Practice Address - Country:US
Practice Address - Phone:847-873-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490178621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical