Robert Travis Brock, MS, LMHP, PLADC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4384 Issued in NE

Practice address

1709 Jackson St
Omaha, NE 68102-2513

Phone

(402) 599-2550

Fax

(402) 599-2565

NPI assigned

Nov 13, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Networks

• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• CO HMO D-SNP
• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO
• CO HMO
• IA HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Omaha, NE
  • NPI 1033985726
  Medicare reassignment NPD
• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Omaha, NE
  • NPI 1134995822
  NPD
• Optum Behavioral Care of Ohio, Inc.

  • Clinical Social Worker
  • Maryland Heights, MO
  • NPI 1528945623
  NPD
• A Better Way Therapy LLC

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1013003623

  Addiction (Substance Use Disorder)

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1023414331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6249 PONDEROSA CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681374277",
            "telephone_number": "402-895-1747",
            "fax_number": "402-599-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 JACKSON ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681022513",
            "telephone_number": "402-599-2550",
            "fax_number": "402-599-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ROBERT",
        "middle_name": "TRAVIS",
        "credential": "MS, LMHP, PLADC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-1258",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Allen Broberg, PLADC
• Renae Brobst
• Naamah Leah Brocco
• Jennifer Lyn Brock, SLP
• Karolynn Chantey Ann Brock
• Lauren Brockevelt, M.S. CCC-SLP
• Makayla Morgan Brockhaus, MD
• Cassie Brockhoff, RN
• Kirsten Marie Brockhoff
• Brian Joseph Brockman, D. C.

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.