Zachary Brock

Primary specialty

CounselorTaxonomy code 101Y00000X

License

39005477A Issued in IN

Practice address

333 E Lewis St
Fort Wayne, IN 46802-3139

Phone

(260) 426-3347

NPI assigned

Aug 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Social Services of Indiana IncGroup PAC ID 7416344262, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Lutheran Social Services of Indiana Inc.

  • Counselor
  • Fort Wayne, IN
  • NPI 1861636136
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1962015404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E LEWIS ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023139",
            "telephone_number": "260-426-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E LEWIS ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023139",
            "telephone_number": "260-426-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "39005477A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Brissette
• Kaitlyn D Brita, NP
• Raymond Britt, RBT
• Laura Marie Britton, BCBA
• Amanda Brock, RN
• Danielle Jean Brockman
• Jinny Renee Broderick, LCSW
• Jamie C Broekhuizen, D.O.
• Margaret Kathleen Bronson, PT
• Brooke Sellhorn LLC

• All providers in Fort Wayne, IN
• Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.