ZACHARY BROCK (NPI# 1962015404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962015404 |
| Entity Type | Individual |
| Full Name | ZACHARY BROCK |
| Practice Address |
2100 Goshen Rd Fort Wayne IN 46808-1493 |
| Mailing Address |
2621 E Jefferson St Warsaw IN 46580-3880 |
| Practice Telephone | 2604713500 |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659896702 | Zachary Shane Brock | Pharmacist | 1 Akron General Ave, Akron, OH 44307-2432 | 2017-08-10 |
| Street Address |
2100 GOSHEN RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46808-1493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902802887 | Shelly J Edwards | Marriage & Family Therapist | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2005-06-24 |
| 1144820192 | Nicholas Ray Brauchler | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-10-29 |
| 1063019610 | Markita R Powell | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-10-07 |
| 1922611458 | Chase Aaron Young | Social Worker | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-25 |
| 1356954887 | Ayomikun Ajani | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-25 |
| 1407467210 | Allyson Thammachack | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-14 |
| 1245841485 | Emily Meller | Social Worker | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-12 |
| 1598383457 | Jessica Mann | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-07-08 |
| 1669097762 | Zabrina Przybilla | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-06-15 |
| 1265057368 | Debra Clevenger | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1407358377 | Bryan Black | Specialist/Technologist | 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 | 2018-03-06 |
| 1326557877 | Kimberly K Kolb | Occupational Therapy Assistant | 1431 Runnion Ave, Fort Wayne, IN 46808 | 2017-09-28 |
| 1396142063 | Christina Ryder | Specialist/Technologist | 3946 Iceway, Fort Wayne, IN 46808 | 2014-11-25 |
| 1912090440 | Neighborcare of Indiana, LLC | Pharmacy | 3402 Congressional Pkwy, Ft. Wayne, IN 46808 | 2006-10-02 |
| 1619945888 | Beth Ann Herrell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2006-03-14 |
| 1568458990 | Carolyn Warner Greer | Obstetrics & Gynecology | 1415 Directors Row, Fort Wayne, IN 46808 | 2005-09-21 |
| 1750851168 | Tyler Cheney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-28 |
| 1487123550 | Michaela Mcguire | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-19 |
| 1861961088 | Olivia Marquardt | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-16 |
| Find all providers in zip 46808 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114401080 | Robin Gene Vandeventer | Counselor | 2200 Lake Ave Ste 225, Fort Wayne, IN 46805-5364 | 2018-09-18 |
| 1023544533 | Emily Martin | Counselor | 4646 W Jefferson Blvd Ste 100, Fort Wayne, IN 46804-6832 | 2017-05-03 |
| 1467995035 | Heather Sue Bleeke | Counselor | 830 Ivy Creek Cv, Fort Wayne, IN 46804-3581 | 2016-11-29 |
| 1437604014 | Donald Luedke | Counselor | 427 W Washington Blvd, Fort Wayne, IN 46802-2915 | 2016-08-24 |
| 1306208400 | Tracy Cain | Counselor | 431 Fairmont Place, Fort Wayne, IN 46808-1116 | 2016-03-28 |
| 1144600982 | Megan Kostrubanic | Counselor | 2420 N Coliseum Blvd Ste 206, Fort Wayne, IN 46805-3139 | 2015-06-07 |
| 1336579754 | Interdisciplinary Community Autism Network, Inc | Counselor | 409 E Cook Rd, Suite 100, Fort Wayne, IN 46825-3600 | 2013-11-21 |
| 1477823151 | Gregory Wayne Isch | Counselor | 7230 Engle Rd Ste 305, Fort Wayne, IN 46804 | 2012-01-11 |
| 1710120753 | Sandra Thomas | Counselor | 5440 Thornbriar Ln, Fort Wayne, IN 46835-3886 | 2009-04-07 |
| 1508034091 | John Patrick Nolan | Counselor | 6015 Dichotomy Ct, Fort Wayne, IN 46835-2063 | 2008-02-18 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46808 |
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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.