Active NPI
Aubrey Lee Brock, RBT
- Behavior Technician
- Granite City, IL
National Provider Identifier
1417846122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1350369
- Practice address
- 2421 Corporate Ctr Ste 100
Granite City, IL 62040-4195 - Phone
- (618) 698-4366
- NPI assigned
- Jun 30, 2025
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB1350369 | IL | Primary |
Addresses
Primary practice location
2421 Corporate Ctr Ste 100
Granite City, IL 62040-4195
Mailing address
919 Southwind CT
Collinsville, IL 62234-1544
Phone (618) 698-4366
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 |
|---|---|---|---|
| BACB1350369 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1417846122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 SOUTHWIND CT",
"city": "COLLINSVILLE",
"state": "IL",
"postal_code": "622341544",
"telephone_number": "618-698-4366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2421 CORPORATE CTR STE 100",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404195",
"telephone_number": "618-698-4366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "AUBREY",
"middle_name": "LEE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-30",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "BACB1350369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.