Active NPI
Zakary G Shrock, LPC
- Mental Health Counselor
- Bandon, OR
National Provider Identifier
1982363156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C10093
- Practice address
- 1346 Strawberry Dr SW
Bandon, OR 97411-8814 - Phone
- (765) 481-9080
- NPI assigned
- Dec 14, 2021
- Last updated
- Mar 6, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C10093 | OR | Primary |
| Mental Health Counselor | 101YM0800X | 6592 | TN |
Addresses
Primary practice location
1346 Strawberry Dr SW
Bandon, OR 97411-8814
Mailing address
1346 Strawberry Dr SW
Bandon, OR 97411-8814
Phone (765) 481-9080
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C10093 | OR | MD | Mental Health Counselor |
| 6592 | TN | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772755200000",
"number": "1982363156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1346 STRAWBERRY DR SW",
"city": "BANDON",
"state": "OR",
"postal_code": "974118814",
"telephone_number": "765-481-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1346 STRAWBERRY DR SW",
"city": "BANDON",
"state": "OR",
"postal_code": "974118814",
"telephone_number": "765-481-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHROCK",
"first_name": "ZAKARY",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-14",
"last_updated": "2026-03-06",
"certification_date": "2026-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C10093",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "6592",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bandon, OR
- Mariarose M Shanahe, LCSW
- Sharon C Strong DMD PC
- Ariel Jui-Yu Shih, PHARMD, RPH
- Shindler's Drugstore Inc. (Shindler's Health Mart Pharmacy)
- Jessica Ann Shrock, FNP--C
- Paul Edward Smith, PT, DPT
- Venus Crystal Smith, D.C
- Southern Coos Health District (Southern Coos Hospital & Health Center)
- Southern Coos Health District
- Southern Coos Health District (SCHHC Retail Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.