MR. KEITH DUANE BROCK (NPI# 1154786812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154786812 |
| Entity Type | Individual |
| Full Name | MR. KEITH DUANE BROCK |
| Practice Address |
7426 S Camino Vahcom Tucson AZ 85757 |
| Mailing Address |
2237 S Mcfee Avenue Tucson AZ 85713 |
| Practice Telephone | 5208795693 |
| Mailing Telephone | 8176813776 |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC-11831 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
7426 S CAMINO VAHCOM |
| City | TUCSON |
| State | AZ |
| Zip Code | 85757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083262984 | Native Mind LLC | Counselor | 6294 S Eagle Talon Pkwy, Tucson, AZ 85757 | 2019-09-03 |
| 1063977007 | El Rio Santa Cruz Neighborhood Health Center Inc | Pharmacy | 7490 So Camino De Oeste, Tucson, AZ 85757 | 2019-02-04 |
| 1447791165 | Juan M. Salgado | Counselor | 7490 S. Camino De Oeste, Tucson, AZ 85757 | 2017-03-14 |
| 1407285224 | Molly Corral | Occupational Therapist | 7420 West Calle Tetakusim, Tucson, AZ 85757 | 2013-11-02 |
| 1972766889 | Albert Mendoza | Respite Care | 4765 W Nebraksa, Tucson, AZ 85757 | 2008-07-10 |
| 1225209125 | Sarah A Dachtyl | Speech-Language Pathologist | 4900 W Calle Don Roberto, Tucson, AZ 85757 | 2008-03-18 |
| 1073603437 | Traci J Otto | Counselor | 7474 South Camino De Oeste, Tucson, AZ 85757 | 2006-10-13 |
| 1942575089 | Adrienne Marie Figueroa | Pharmacist | 7900 S J Stock Rd, Tucsonh, AZ 85757 | 2012-03-21 |
| 1790961233 | Tim Mark Hannah | Community Based Residential Treatment Facility, Mental Illness | 4901 W Calle Don Alfonso, Tucson, AZ 85757-1422 | 2008-01-15 |
| 1255478889 | Crisanta T Hannah | Community Based Residential Treatment Facility, Mental Illness | 7151 W Valley Stream Drive, Tucson, AZ 85757-1422 | 2007-01-31 |
| Find all providers in zip 85757 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811509581 | Creosote Mental Health Group | Counselor | 4646 N Swan Rd Ste 105, Tucson, AZ 85718-6715 | 2020-08-23 |
| 1497366314 | Cachora Standifer | Counselor | 6294 S Eagles Talon Pkwy, Tucson, AZ 85757-1639 | 2020-08-13 |
| 1508490673 | Terrence Hickey | Counselor | 11235 E Sundance Dr, Tucson, AZ 85749-8280 | 2020-02-27 |
| 1568092815 | Travis Anderson | Counselor | 2002 W Anklam Rd, Tucson, AZ 85745-2148 | 2020-01-24 |
| 1740830447 | Let All Thrive, LLC | Counselor | 1580 N Kolb Rd Ste 200, Tucson, AZ 85715-4933 | 2019-09-13 |
| 1316424526 | Wendy Sizer LLC | Counselor | 425 W Paseo Redondo Apt 3b, Tucson, AZ 85701-8258 | 2018-07-20 |
| 1841705043 | Cynthia Miller Potter | Counselor | 4144 E Broadway Blvd, Tucson, AZ 85711-3455 | 2017-12-10 |
| 1447791165 | Juan M. Salgado | Counselor | 7490 S. Camino De Oeste, Tucson, AZ 85757 | 2017-03-14 |
| 1447701867 | Katheryn Fredman | Counselor | 3830 E. Bellevue St., Tucson, AZ 85716 | 2016-10-20 |
| 1104374255 | Shannon Dexter Petrovich | Counselor | 5855 N Kolb Rd Unit 4208, Tucson, AZ 85750-0991 | 2016-09-19 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.