Active NPI
Charlene E Broock, MSW, LICSW
- Professional Counselor
- Rio Rancho, NM
National Provider Identifier
1790731800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C-08797
- Practice address
- 1005 21St St SE
Ste B
Rio Rancho, NM 87124-4030 - Phone
- (781) 454-8015
- NPI assigned
- May 26, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C-08797 | NM | Primary |
Addresses
Primary practice location
1005 21St St SE
Ste B
Rio Rancho, NM 87124-4030
Mailing address
1005 21St St SE
Ste B
Rio Rancho, NM 87124-4030
Phone (781) 454-8015
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790731800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 21ST ST SE",
"address_2": "STE B",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871244030",
"telephone_number": "781-454-8015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 21ST ST SE",
"address_2": "STE B",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871244030",
"telephone_number": "781-454-8015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOCK",
"first_name": "CHARLENE",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "C-08797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.