Robert Henry Brick, ED D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY3985 Issued in FL

Practice address

5210 Linton Blvd
Suite 204
Delray Beach, FL 33484-6542

Phone

(561) 638-3839

Fax

(561) 638-3379

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1174510176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 LINTON BLVD.",
            "address_2": "SUITE 204",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846537",
            "telephone_number": "561-638-3839",
            "fax_number": "561-638-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 LINTON BLVD",
            "address_2": "SUITE 204",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846542",
            "telephone_number": "561-638-3839",
            "fax_number": "561-638-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICK",
        "first_name": "ROBERT",
        "middle_name": "HENRY",
        "credential": "ED D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS4764 L",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY3985",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS4764 L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3985",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.