Active NPI
Cary Elizabeth Leatherwood Brock, LPC
- Mental Health Counselor
- Dalton, GA
National Provider Identifier
1417410267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC010903
- Practice address
- 1414 Dug Gap Rd
Dalton, GA 30720-5007 - Phone
- (706) 279-0405
- NPI assigned
- Apr 9, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC010903 | Primary |
Addresses
Primary practice location
1414 Dug Gap Rd
Dalton, GA 30720-5007
Mailing address
253 Cash Rd NE
Calhoun, GA 30701-9717
Phone (706) 676-0262
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family and Children First LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1770627515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1417410267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "253 CASH RD NE",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307019717",
"telephone_number": "706-676-0262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 DUG GAP RD",
"city": "DALTON",
"state": "GA",
"postal_code": "307205007",
"telephone_number": "706-279-0405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEATHERWOOD BROCK",
"first_name": "CARY",
"middle_name": "ELIZABETH",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-09",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": "LPC010903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.