MRS. ANDREA R BROCKMAN (NPI# 1295275097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295275097 |
| Entity Type | Individual |
| Full Name | MRS. ANDREA R BROCKMAN |
| Credential | N.C.C., L.M.H.C. |
| Practice Address |
4024 Central Ave Saint Petersburg FL 33711-1239 |
| Practice Telephone | 7273277656 |
| Practice Fax Number | 7273288978 |
| Mailing Telephone | 7273277656 |
| Mailing Fax Number | 7273288978 |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2020-03-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH17599 | FL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
180010802 | IL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
178011935 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1344 22nd St S, Saint Petersburg, FL 337122744 | 7278216701 | |
| 330 Sw Washington St, Peoria, IL 616021406 | 3096762400 | 3096766022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043519929 | Andrea Rae Brockman | Physician Assistant | 13005 State Road 80, Loxahatchee, FL 33470-9206 | 2011-03-18 |
| Street Address |
4024 CENTRAL AVE |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33711-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023581147 | Jessica S Archiquette | Counselor | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2019-01-11 |
| 1770053605 | Erin Conte | Counselor | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2018-12-04 |
| 1902386907 | Shana J Harper | Social Worker | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2018-08-19 |
| 1649728460 | Edward Williams | Social Worker | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2016-09-21 |
| 1023566783 | Anika Dzik | Case Manager/Care Coordinator | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2016-09-12 |
| 1215325204 | Natasha Nixon | Licensed Practical Nurse | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2014-12-30 |
| 1477811255 | Cyndie Campbell | Counselor | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2012-04-30 |
| 1043591555 | David Nathaniel Newby | Registered Nurse | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2011-08-30 |
| 1457650194 | Katherine Dan Salkovitz | Marriage & Family Therapist | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2011-03-21 |
| 1710281191 | Julio Antonio Burgos | Counselor | 4024 Central Ave, Saint Petersburg, FL 33711-1239 | 2010-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639665110 | Armando Alvarez Gonzalez | Nurse Practitioner | 3404 26th Ave S, St Petersburg, FL 33711 | 2018-07-08 |
| 1508398843 | S&r Cares LLC | Preferred Provider Organization | 4201 4th Avenue South Street, St Petersburg, FL 33711 | 2017-03-28 |
| 1245691062 | Brian Paulson | Counselor | 4024 Central Ave # 1239, Saint Petersburg, FL 33711 | 2016-03-08 |
| 1871966069 | Kelly Jean Plant | Home Health Aide | 3611 3rd Ave South, St Petersburg, FL 33711 | 2015-11-10 |
| 1750784815 | Honor Investments LLC | Community/Behavioral Health | 4750 Dophin Cay Ln S, #508, St Petersburg, FL 33711 | 2014-10-03 |
| 1063771947 | Vincent Ford | Physical Therapy Assistant | 3479 22nd Avenue, St.petersburg, FL 33711 | 2012-05-11 |
| 1568758571 | Ashley Lauren Taliaferro | Physical Therapist | 5042 42nd St S, Saint Petersburg, FL 33711 | 2011-06-28 |
| 1801180187 | Karen Lynn Wilcox | Massage Therapist | 2026 44th Street S, Saint Petersburg, FL 33711 | 2011-06-04 |
| 1881998722 | Martha L Allen | Assisted Living Facility | 1860 46 Street South, St. Petersburg, FL 33711 | 2011-01-07 |
| 1760519052 | Scg Palazzo Operator, LLC | Assisted Living Facility | 3600 34th St South, St Augustine, FL 33711 | 2007-02-27 |
| Find all providers in zip 33711 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942814314 | Juanita Suber Athy | Counselor | 2900 Pallanza Dr S, Saint Petersburg, FL 33705-3608 | 2020-09-03 |
| 1649880949 | Alan Cyr | Counselor | 433 Rotary Pl Ne, Saint Petersburg, FL 33703-1540 | 2020-08-03 |
| 1013554435 | Samantha Brustad | Counselor | 9887 4th St N Ste 319, Saint Petersburg, FL 33702-8445 | 2019-12-04 |
| 1740751171 | Rmr Counseling LLC | Counselor | 2961 1st Ave N Ste F, Saint Petersburg, FL 33713-8605 | 2018-12-11 |
| 1033658810 | Jennifer Sewell | Counselor | 3900 Shore Acres Blvd Ne, Saint Petersburg, FL 33703-5404 | 2017-02-14 |
| 1245691062 | Brian Paulson | Counselor | 4024 Central Ave # 1239, Saint Petersburg, FL 33711 | 2016-03-08 |
| 1174993596 | Nicolette Laine Guzie | Counselor | 2100 45th Ave N, Saint Petersburg, FL 33714-4136 | 2015-09-28 |
| 1427438662 | Denise Eva Gibbons | Counselor | 1735 Dr Martin Luther King St S, Saint Petersburg, FL 33705-2404 | 2015-06-03 |
| 1174921977 | New Transition Therapy, LLC | Counselor | 400 39th Ave S, Saint Petersburg, FL 33705-3936 | 2014-12-10 |
| 1225465586 | David Martin Loggans II | Counselor | 4501 33rd Ave N, Saint Petersburg, FL 33713-1103 | 2013-10-02 |
| Find all providers in SAINT PETERSBURG | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33711 |
Please comment or provide details below to improve the information on MRS. ANDREA R BROCKMAN.
| 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.