BROCK FAMILY THERAPY CENTER INC. NPI 1609250992

NPI Information

NPI: 1609250992
Provider Name: BROCK FAMILY THERAPY CENTER INC.
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
10300 BROOKRIDGE VILLAGE BLVD
SUITE 104
LOUISVILLE, KY
ZIP 40291
Phone: (502) 785-4322
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BROCK FAMILY THERAPY CENTER INC. is an adult mental health clinic center in Louisville, KY. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. BROCK FAMILY THERAPY CENTER INC. NPI is 1609250992. The provider is registered as an organization entity type.

The provider's business location address is:

10300 BROOKRIDGE VILLAGE BLVD
SUITE 104
LOUISVILLE, KY
ZIP 40291
Phone: (502) 785-4322
Fax: (502) 785-4433

The provider's authorized official is Angela C Brock .
The authorized official title is Principal Therapist/owner and has the following contact phone number (502) 785-4322.

The enumeration date for this NPI number is 7/16/2015 and was last updated on 8/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	3035	KENTUCKY	No
2	261QM0850X	Clinic/Center	Adult Mental Health	0617	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100068240	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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