Individual provider Active NPI

Sandra Ann Brock, LCSW

  • Clinical Social Worker
  • Missouri City, TX
National Provider Identifier
1295742963
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27130 Issued in TX
Practice address
2927 Shiloh Dr
Missouri City, TX 77459-4935
Phone
(281) 438-0585
Fax
(281) 438-0595
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27130 TX Primary

Addresses

Primary practice location

2927 Shiloh Dr
Missouri City, TX 77459-4935

Mailing address

2927 Shiloh Dr
Missouri City, TX 77459-4935
Phone (281) 438-0585

Other identifiers 1

IdentifierTypeStateIssuer
037740001MedicaidTX

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
27130TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Geriatric Services Inc Past Accepting new patients
Parkview Psychological Services, PC PastSince Sep 21, 2013 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1295742963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 SHILOH DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594935",
            "telephone_number": "281-438-0585",
            "fax_number": "281-438-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 SHILOH DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594935",
            "telephone_number": "281-438-0585",
            "fax_number": "281-438-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "27130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037740001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.