Alexander Patrick Brock, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5601 Issued in OR

Practice address

1515 Liberty St SE
Salem, OR 97302-4345

Phone

(503) 951-6280

Fax

(503) 468-3130

NPI assigned

Oct 18, 2017

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Forging Paths Counseling, LLC

  • Mental Health Counselor
  • Salem, OR
  • NPI 1790467488
  NPD Authorized official
• Options Counseling Services of Oregon

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1548275217
  NPD

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1114438181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024345",
            "telephone_number": "503-951-6280",
            "fax_number": "503-468-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024345",
            "telephone_number": "503-951-6280",
            "fax_number": "503-468-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ALEXANDER",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-18",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas L Bristol, M.D.
• Ashlee Kay Britton, CADC-R
• BRMS LLC
• Mia Elise Broberg
• Brock J Nelson DMD LLC
• Erin R Brock, DMD
• Kristie Lyn Brock, PTA
• Dawn Renae Brockett
• Howard Laurence Brockman, LCSW
• Kevin Brockman

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.