Olivia Kathryn White Brock, MS, NCC, LPC, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC013147 Issued in PA

Practice address

287 Lorton Ave
Burlingame, CA 94010-4203

Phone

(877) 505-7147

NPI assigned

Apr 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1053992123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 LORTON AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104203",
            "telephone_number": "877-505-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 LORTON AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104203",
            "telephone_number": "877-505-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE BROCK",
        "first_name": "OLIVIA",
        "middle_name": "KATHRYN",
        "credential": "MS, NCC, LPC, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "1099274",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61227686",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC013147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "owhite@lyraclinical.com",
            "affiliation": "N",
            "address_1": "287 Lorton Ave",
            "city": "Burlingame",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940104203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Whalen, ATC, PT
• Cara Barry Wharton, LMFT
• Wheelchairs of San Mateo
• Aileen Whelan, M.D.
• Andria Whipple, LPC
• Christopher Dawson White, M.D.
• Frances-Anne Anonas White, MSN,RN,FNP
• Erik Joseph Wilk, MD
• Jeremy M Wilkinson, MD
• Andrew Scott Willard

• Professional Counselor in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.