Jeffrey Clarke Brockman, LPCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A13433 Issued in NC

Practice address

15028 Rothesay Dr
Charlotte, NC 28277-1997

Phone

(704) 365-7777

NPI assigned

Nov 15, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1104339944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15028 ROTHESAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282771997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15028 ROTHESAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282771997",
            "telephone_number": "704-365-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "JEFFREY",
        "middle_name": "CLARKE",
        "name_prefix": "Dr.",
        "credential": "LPCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A13433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Broady
• Melanie H Brocato, CPO
• Hayley Keen Brock, OTR/L
• Jack Gilbert Brock Jr., M.D.
• Krystal Dawn Brock, LMFTA
• Kathryn Elizabeth Brockway, PA-C
• Staci Huska Broderick, M.S. CCC-SLP
• Shawnte N Brodie
• Megan Colleen Brogan, FNP
• Leigh Brogdon, PT

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.