Brock Sellers, LICSW, PIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2292-C Issued in AL

Practice address

5330 Stadium Trace Pkwy
Hoover, AL 35244-4525

Phone

(205) 490-6983

NPI assigned

Jan 30, 2023

Last updated

Jan 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Full Well Neurofeedback LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hoover, AL
  • NPI 1083297246
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1376259721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 SAPPHIRE RDG",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444172",
            "telephone_number": "205-310-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 STADIUM TRACE PKWY",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444525",
            "telephone_number": "205-490-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "BROCK",
        "credential": "LICSW, PIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2292-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Nicole Seay, CRNP
• Second Bloom Counseling, LLC
• Self Reliance Behavioral Health, LLC
• Samuel L Self Jr., RPH
• Sellers & Associates LLC
• Michele Dooley Sellers, LPC
• Send Me an Angel Sitters LLC
• Kathleen C Sentell, PAC
• Serenity Palliative & Hospice Care
• Leslie Elise Sessions, CRNP

• Clinical Social Worker in Hoover, AL
• Providers in Hoover, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.