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General NPI Number Information
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NPI Number | 1548082746
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Entity Type | Organization
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Legal Business Name | ADAM BROCK COUNSELING
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 2822 W STOLLEY PARK RD STE 101
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City | GRAND ISLAND
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State | NE
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Zip | 68801-6806
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Country | US
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Telephone | 308-930-9923
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Fax |
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Provider Business Mailing Address
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Address Line | 4505 CALVIN DR
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City | GRAND ISLAND
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State | NE
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Zip | 68801-8715
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Country | US
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Telephone | 308-930-9923
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | ADAM BROCK
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Credential | PLMHP
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Telephone | 308-930-9923
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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 |
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License Number State |
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