DISA T. BROCK (NPI# 1154961746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154961746 |
| Entity Type | Individual |
| Full Name | DISA T. BROCK |
| Practice Address |
2520 N University Ave # 250a Provo UT 84604-3804 |
| Mailing Address |
1211 E 2080 N Provo UT 84604-2147 |
| Practice Telephone | 8013378277 |
| Mailing Telephone | 8017535543 |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
9093412-4408 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
2520 N UNIVERSITY AVE # 250A |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902099385 | Marlene Zouein Blaizot | Psychiatry & Neurology | 1300 East Center Street, Utah State Hospital, Provo, UT 84603-0000 | 2007-08-20 |
| 1578662508 | William Bunn | Psychiatry & Neurology | 2520 N University Ave # 250, Provo, UT 84604-3804 | 2006-09-22 |
| 1982147377 | Strive Mental Health | Psychiatry & Neurology | 2520 N University Ave # 250, Provo, UT 84604-3804 | 2016-12-02 |
| 1659626430 | Nathan Karl Maeser | Psychiatry & Neurology | 1157 N 300 W, Suite 303, Provo, UT 84604-6124 | 2012-07-18 |
| 1639469398 | Micah Eldredge Croft | Psychiatry & Neurology | 1034 N 500 W, Provo, UT 84604-3380 | 2011-04-14 |
| 1134355001 | Matthew Swenson | Psychiatry & Neurology | 1034 N 500 W, Provo, UT 84604-3380 | 2009-06-05 |
| 1912163742 | Paul D Whitehead | Psychiatry & Neurology | 1300 E Center Street, Provo, UT 84606-3554 | 2008-07-31 |
| 1750547584 | Cynthia Louise Vitko | Psychiatry & Neurology | 1300 E Center Street, Provo, UT 84606-3554 | 2008-07-31 |
| 1962686998 | Robert H Crist | Psychiatry & Neurology | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2007-12-27 |
| 1225122187 | Brad Lynn Murray | Psychiatry & Neurology | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2006-10-03 |
| Find all providers in PROVO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.