Active NPI
Michael L. Brock, LPC-S
- Counselor
- Dallas, TX
National Provider Identifier
1417290909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 19521
- Practice address
- 12800 Hillcrest Rd
Suite A126
Dallas, TX 75230 - Phone
- (214) 364-4154
- NPI assigned
- Apr 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 19521 | TX | Primary |
Addresses
Primary practice location
12800 Hillcrest Rd
Suite A126
Dallas, TX 75230
Mailing address
12800 Hillcrest Rd
Suite A126
Dallas, TX 75230
Phone (214) 364-4154
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 |
|---|---|---|---|
| 19521 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1417290909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12800 HILLCREST RD",
"address_2": "SUITE A126",
"city": "DALLAS",
"state": "TX",
"postal_code": "75230",
"telephone_number": "214-364-4154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12800 HILLCREST RD",
"address_2": "SUITE A126",
"city": "DALLAS",
"state": "TX",
"postal_code": "75230",
"telephone_number": "214-364-4154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "MICHAEL",
"middle_name": "L.",
"name_prefix": "Mr.",
"credential": "LPC-S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-03",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "19521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.