BROCK FAMILY THERAPY CENTER INC. (NPI# 1609250992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609250992 |
| Entity Type | Organization |
| Organization Name | BROCK FAMILY THERAPY CENTER INC. |
| Practice Address |
10300 Brookridge Village Blvd Suite 104 Louisville KY 40291 |
| Practice Telephone | 5027854322 |
| Practice Fax Number | 5027854433 |
| Mailing Telephone | 5027854322 |
| Mailing Fax Number | 5027854433 |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2016-11-18 |
| Authorized Official Name | MRS. ANGELA C BROCK (PRINCIPAL THERAPIST/OWNER) |
| Authorized Official Telephone | 5027854322 |
| Authorized Official Credential | LCSW, LMFT, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
0617 | KY | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
3035 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100068240 | 05 |
| Street Address |
10300 BROOKRIDGE VILLAGE BLVD SUITE 104 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750428595 | Christy Howard | Social Worker | 10300 Brookridge Village Blvd, Suite 202, Louisville, KY 40291-4474 | 2007-01-31 |
| 1144728759 | Ellen Taylor Kimball | Social Worker | 10300 Brookridge Village Blvd, Louisville, KY 40291-4474 | 2018-01-29 |
| 1437507175 | Denise Glover | Social Worker | 10300 Brookridge Village Blvd, Suite 104, Louisville, KY 40291-4474 | 2016-06-02 |
| 1649512047 | Safari Kidz Kounseling LLC | Social Worker | 10300 Brookridge Village Blvd, Suite 202, Louisville, KY 40291-4474 | 2013-03-23 |
| 1073734927 | Angela Christina Brock | Social Worker | 10300 Brookridge Village Blvd, Suite 104, Louisville, KY 40291 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881117166 | The Degondaba School, Inc. | Day Training, Developmentally Disabled Services | 5110 Stony Brook Drive, Louisville, KY 40291 | 2017-07-19 |
| 1497108278 | Andrea Herndon | Physician Assistant | 10710 Marceitta Ct, Louisville, KY 40291 | 2016-07-18 |
| 1033536602 | Jennifer Rose Fowler | Social Worker | 10300 Brookridge Villeage Blvd., Suite 104, Louisville, KY 40291 | 2014-03-21 |
| 1740602069 | Brittney Tatum | Licensed Practical Nurse | 9500 Glen Trace Ln, Louisville, KY 40291 | 2014-01-07 |
| 1326392895 | Lisa J Fetter | Nurse Practitioner | 6413 Bardstown Rd, Louisville, KY 40291 | 2012-11-05 |
| 1275829137 | Carolyn Estep Book | Counselor | 9612 Farmstead Lane, Louisville, KY 40291 | 2011-06-20 |
| 1023309028 | Julie Klein Hawkins | Pharmacist | 8014 Bardstown Rd., Louisville, KY 40291 | 2011-04-25 |
| 1295872653 | Loving Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9508 Fairmount Rd, Louisville, KY 40291 | 2007-02-01 |
| 1962548198 | Morgan Howard | Chiropractor | 5501 Bardstown Rd, Louisville, KY 40291 | 2007-01-29 |
| 1407992258 | Deanna H Smith | Social Worker | 9409 Cedar Look Drive, Louisville, KY 40291 | 2007-01-29 |
| Find all providers in zip 40291 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730532 | Reflection In Practice Counseling and Consultation | Clinic/Center | 1355 Bardstown Rd, Louisville, KY 40204-1353 | 2020-11-03 |
| 1568069326 | Evolve Lou Counseling | Clinic/Center | 1309 Cecil Ave, Louisville, KY 40211-2418 | 2020-10-05 |
| 1356987929 | Faraday Kentucky, LLC | Clinic/Center | 10000 Shelbyville Rd Ste 101, Louisville, KY 40223-2973 | 2019-11-19 |
| 1275010449 | Inspire&empower LLC | Clinic/Center | 1169 Eastern Pkwy Ste 2339, Louisville, KY 40217-1415 | 2018-07-20 |
| 1295233948 | Thrive Therapy LLC | Clinic/Center | 13000 Equity Pl Ste 106, Louisville, KY 40223-3976 | 2018-01-29 |
| 1952621005 | Lifeworks of Kentucky | Clinic/Center | 1531 Ormsby Station Ct, Louisville, KY 40223-4019 | 2010-06-10 |
| 1528670320 | Allison King, Lpcc, LLC | Clinic/Center | 1949 Goldsmith Ln Ste 103, Louisville, KY 40218-3096 | 2020-08-21 |
| 1285272088 | Heartwood Therapy Place LLC | Clinic/Center | 1941 Bishop Ln Ste 1019, Louisville, KY 40218-1928 | 2019-12-12 |
| 1669967287 | Fresh Routes Incorporated | Clinic/Center | 3146 W Broadway, Louisville, KY 40211-1441 | 2018-06-26 |
| 1902309214 | Chandler Behavioral Health Resources | Clinic/Center | 9400 Williamsburg Plz, Louisville, KY 40222-5093 | 2018-03-13 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40291 |
Please comment or provide details below to improve the information on BROCK FAMILY THERAPY CENTER INC..
| 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.