Dorothy Brock, PHD
Individual provider Active NPI Psychologist · Franklin Springs, GA
NPI 1780348128 · NPPES record last updated Oct 22, 2021
Key facts
- NPI
- 1780348128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PSY001566 (GA)
- Practice address
- 63 Springs Station Dr
Franklin Springs, GA 30639 - Phone
- (706) 246-0733
- NPI assigned
- Oct 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211104001753 | GA | Practitioner - Clinical Psychologist | 2860880259 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY001566 | GA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellsprings Counseling Services LLC | Current |
Accepting new patients | |
| Beverly J Oxley, PHD PC | Psychologist | Current |
Accepting new patients |
| Harold G. Rhoades PH.D. P.C. | Psychologist | Past |
Accepting new patients |
Locations
63 Spring Station Rd
Royston, GA 30662
Phone (706) 246-0733
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY001566 | GA | Yes |
Addresses
Primary practice location
63 Springs Station Dr
Franklin Springs, GA 30639
Mailing address
63 Springs Station Dr
Franklin Springs, GA 30639
Phone (706) 246-0733
Other providers in Franklin Springs, GA
- Tammy Arnold
- Adam L Beadles
- Beverly J Oxley, PHD PC
- Keena D Bodine
- Emmanuel College
- Elizabeth Shannon Gilchrest
- Courtney Glueck
- Harold G. Rhoades PH.D. P.C.
- Kristina Hart
All providers in Franklin Springs, GA · Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.