Individual provider Active NPI

Elliot Brock

  • Professional Counselor
  • Hammond, LA
National Provider Identifier
1477094969
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
835 Pride Dr Ste B
Hammond, LA 70401-9527
Phone
(985) 543-4730
Fax
(985) 543-4752
NPI assigned
Mar 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

835 Pride Dr Ste B
Hammond, LA 70401-9527

Mailing address

835 Pride Dr Ste B
Hammond, LA 70401-9527
Phone (985) 543-4730

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

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1477094969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 PRIDE DR STE B",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704019527",
            "telephone_number": "985-543-4730",
            "fax_number": "985-543-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 PRIDE DR STE B",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704019527",
            "telephone_number": "985-543-4730",
            "fax_number": "985-543-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ELLIOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.