Shalena Chantel Brock, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

54859 Issued in TX

Practice address

509 Abraham CT
Irving, TX 75060-6961

Phone

(469) 412-5140

Fax

(214) 614-4153

NPI assigned

Aug 31, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Community Network Alliance Group

  • Case Management Agency
  • Irving, TX
  • NPI 1477987626
  NPD (past)

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

{
    "created_epoch": "1409443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409443200000",
    "number": "1922408665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 ABRAHAM CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750606961",
            "telephone_number": "469-412-5140",
            "fax_number": "214-614-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 ABRAHAM CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750606961",
            "telephone_number": "469-412-5140",
            "fax_number": "214-614-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SHALENA",
        "middle_name": "CHANTEL",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-31",
        "last_updated": "2014-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "54859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS HEALTH STEPS",
            "identifier": "22004798",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Ashley Bristow, D. D. S.
• Margaret Broadhead, DNP, CRNA
• Preston Broadhead, DNP, CRNA
• Adam C Brock, FNP
• Joel Brandon Brock, NP-C, DC
• Ted P. Bronson, M.D.
• Meredith Broussard Sorokwasz, M.A., CCC-SLP
• Emma L Broussard, NONE
• Rebecca Broussard
• Candice Lynn Brown Addison, MD

• Social Worker in Irving, TX
• Providers in Irving, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2014; 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.