Simone Elizabeth Brock, LAC – Mental Health Counselor

Key facts

NPI: 1972313484
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: A2501003 (AR)
Practice address: 271 Austin Loop
El Paso, AR 72045-9613
Phone: (972) 342-1696
NPI assigned: Jan 8, 2025
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
A2501003	AR	MD	Mental Health Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	A2501003	AR	Yes

Addresses

Primary practice location

271 Austin Loop
El Paso, AR 72045-9613

Mailing address

271 Austin Loop
El Paso, AR 72045-9613
Phone (972) 342-1696

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 8, 2025.

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1972313484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 AUSTIN LOOP",
            "city": "EL PASO",
            "state": "AR",
            "postal_code": "720459613",
            "telephone_number": "972-342-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 AUSTIN LOOP",
            "city": "EL PASO",
            "state": "AR",
            "postal_code": "720459613",
            "telephone_number": "972-342-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SIMONE",
        "middle_name": "ELIZABETH",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2501003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, AR

All providers in El Paso, AR · Mental Health Counselor in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.