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General NPI Number Information
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NPI Number | 1003024738
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Entity Type | Individual
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Provider Name | CATHERINE M. BROCK MA, LMHC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 5855 E NAPLES PLZ STE 206
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City | LONG BEACH
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State | CA
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Zip | 90803-5079
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Country | US
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Telephone | 425-891-3749
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 CAMELBACK ST UNIT 7476
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City | NEWPORT BEACH
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State | CA
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Zip | 92658-1223
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Country | US
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Telephone | 425-891-3749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH 00009706
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License Number State | WA
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