Active NPI
Jillian Brock
- Counselor
- Bremerton, WA
National Provider Identifier
1235901802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG61490105
- Practice address
- 5455 Almira Dr NE
Bremerton, WA 98311-8330 - Phone
- (360) 373-5031
- NPI assigned
- Oct 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG61490105 | WA | Primary |
Addresses
Primary practice location
5455 Almira Dr NE
Bremerton, WA 98311-8330
Mailing address
5455 Almira Dr NE
Bremerton, WA 98311-8330
Phone (360) 373-5031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG61490105 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kitsap Mental Health Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Bremerton, WA
- NPI 1033268008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1235901802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR NE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR NE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "JILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-26",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61490105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.