Kathryn M Brock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-11496 Issued in NM

Practice address

5200 Pasadena Ave NE Unit E
Albuquerque, NM 87113-2208

Phone

(505) 796-6367

Fax

(505) 533-2135

NPI assigned

Nov 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kathryn M Gonzales Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mandala Integrated Therapy LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1225763568

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1851058952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 PASADENA AVE NE UNIT E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132208",
            "telephone_number": "505-796-6367",
            "fax_number": "505-533-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PASADENA AVE NE UNIT E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132208",
            "telephone_number": "505-796-6367",
            "fax_number": "505-533-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NM",
            "license": "C-11496",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "GONZALES",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey Broadwell, RPH
• Chelsey N Brock
• Cynthia Brock, LISW
• Jack A Brock, M.D.
• Kara Brock
• Maria Tonita Brock, L.I.S.W.
• Meridith James Brock, LPCC, LPC
• Sonja Brock, MD
• Lucy M Brockman
• Elisabeth Brodersen, R.N.

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.