Healthcare Provider Details

I. General information

NPI: 1891660361
Provider Name (Legal Business Name): BROCK VENTURES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 WASHINGTON RD STE 206
MC MURRAY PA
15317-2534
US

IV. Provider business mailing address

4150 WASHINGTON RD STE 206
MC MURRAY PA
15317-2534
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-3627
  • Fax: 724-941-3667
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. RUEBEN BROCK
Title or Position: PRESIDENT
Credential: PHD
Phone: 724-941-3627