Seiji Brock, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-8176 Issued in ID

Practice address

4552 N Citrus Ave
Boise, ID 83713-9556

Phone

(208) 402-6974

NPI assigned

Oct 16, 2018

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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Blue Sage Counseling, LLC

  • Mental Health Counselor
  • Boise, ID
  • NPI 1528884756
  NPD Authorized official
• Family Counseling Services

  • Developmentally Disabled Services Day Training Agency
  • Meridian, ID
  • NPI 1245782358
  NPD (past)
• Family Counseling Services Inc

  • Mental Health Counselor
  • Meridian, ID
  • NPI 1427352921
  NPD (past)

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1407322589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4552 N CITRUS AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837139556",
            "telephone_number": "208-861-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4552 N CITRUS AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837139556",
            "telephone_number": "208-402-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SEIJI",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-8176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broader Wellness, LLC
• Christopher Broadnax
• Broadway Chiropractic Center Professional Association
• Hanna Brock
• Natalie Brock, FNP
• Debra Jean Brockert, LMSW
• Daniel J Broderick, DO
• Melva June Broderick, R.N.
• Thomas W Broderick, M.D.
• Bronco Senior Services (Hillcrest)

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.