Active NPI
Kenneth Martin Deblock, LPC
- Professional Counselor
- Independence, MO
National Provider Identifier
1336482215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2013008640
- Practice address
- 3205 N Twyman Rd
Independence, MO 64058-3211 - Phone
- (816) 249-5371
- NPI assigned
- Mar 29, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2013008640 | MO | Primary |
Addresses
Primary practice location
3205 N Twyman Rd
Independence, MO 64058-3211
Mailing address
3205 N Twyman Rd
Independence, MO 64058-3211
Phone (816) 249-5371
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 |
|---|---|---|---|
| 2013008640 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1336482215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 N TWYMAN RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640583211",
"telephone_number": "816-249-5371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3205 N TWYMAN RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640583211",
"telephone_number": "816-249-5371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBLOCK",
"first_name": "KENNETH",
"middle_name": "MARTIN",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-29",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2013008640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.