MEDICARE: DAVID BROCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LPCC.0024444	CO

General Provider Information

NPI Number	:	1962338657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BROCK

Provider Business Mailing Address
First Line	:	1123 FLORENCE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-3547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 OLD RANCH RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-4528
Country	:	US
Telephone Number	:	719-528-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2026
Last Update Date	:	06/20/2026

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Directions to “ DAVID BROCK ” Practice Location

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