MICHAEL BROCK LICSW NPI 1740351121

NPI Information

NPI: 1740351121
Provider Name: MICHAEL BROCK, LICSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
7 HAVILAND ST
BOSTON, MA
ZIP 02115
Phone: (617) 267-0900
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Michael Brock, LICSW is a mental health counselor in Boston, MA. Michael Brock, LICSW NPI is 1740351121. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7 HAVILAND ST
BOSTON, MA
ZIP 02115-683
Phone: (617) 267-0900
Fax: (617) 267-3667

The enumeration date for this NPI number is 11/10/2006 and was last updated on 7/9/2007.

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	101YM0800X	Counselor	Mental Health	107584	MASSACHUSETTS	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	Y101387	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	MEDICARE B
2	221867	MEDICARE OSCAR/CERTIFICATION	MASSACHUSETTS
3	1303546	MEDICAID	MASSACHUSETTS

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: 11/14/2023

NPI Synchronization or Removal

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