Individual provider Active NPI

Tricia Marie Brock, MFA, LP

  • Psychoanalyst
  • New York, NY
National Provider Identifier
1558732214
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
001045 Issued in NY
Practice address
60 W 10TH St Apt 6B
New York, NY 10011-8705
Phone
(347) 804-8807
NPI assigned
Oct 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 001045 NY Primary

Addresses

Primary practice location

60 W 10TH St Apt 6B
New York, NY 10011-8705

Mailing address

60 W 10TH St Apt 6B
New York, NY 10011-8705
Phone (347) 804-8807

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
Credentials
Master of Fine Arts

State licenses

LicenseStateTypeSpecialty
001045NYMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1558732214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W 10TH ST APT 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118705",
            "telephone_number": "347-804-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W 10TH ST APT 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118705",
            "telephone_number": "347-804-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "TRICIA",
        "middle_name": "MARIE",
        "credential": "MFA, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "001045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.