Active NPI
Melissa Rhynes Brock, LPC LCAS
- Professional Counselor
- Fayetteville, NC
National Provider Identifier
1992042105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9392
- Practice address
- 1310 Raeford Rd
Suite 2
Fayetteville, NC 28305-5085 - Phone
- (910) 364-5799
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 9392 | NC | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3124 | NC |
Addresses
Primary practice location
1310 Raeford Rd
Suite 2
Fayetteville, NC 28305-5085
Mailing address
1313 General Lee Ave
Fayetteville, NC 28305-4815
Phone (910) 364-5799
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 |
|---|---|---|---|
| 3124 | NC | MD | Clinical Psychologist |
| 9392 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415836800000",
"number": "1992042105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 GENERAL LEE AVE",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283054815",
"telephone_number": "910-364-5799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 RAEFORD RD",
"address_2": "SUITE 2",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055085",
"telephone_number": "910-364-5799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "MELISSA",
"middle_name": "RHYNES",
"credential": "LPC LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2014-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "9392",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "3124",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.