MRS. JESSECA RAE BROCKMAN (NPI# 1215242946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215242946 |
| Entity Type | Individual |
| Full Name | MRS. JESSECA RAE BROCKMAN |
| Credential | LCDC, LPC |
| Practice Address |
3417 73rd St Ste A Lubbock TX 79423-1125 |
| Practice Telephone | 8065001345 |
| Mailing Telephone | 8065001345 |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2018-10-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
10900 | TX | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
64393 | TX | Behavioral Health & Social Service Providers |
| Street Address |
3417 73RD ST STE A |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79423-1125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427674399 | Nicole Lynn Rosteski | Student in an Organized Health Care Education/Training Program | 3101 96th St, Lubbock, TX 79423 | 2020-06-17 |
| 1003399742 | Patricia Marshel Price | Licensed Vocational Nurse | 1520 B 82nd, Lubbock, TX 79423 | 2018-09-10 |
| 1386123115 | Ashley Nichole Avalos | Licensed Vocational Nurse | 19109 County Road 2400, Lubbock, TX 79423 | 2018-08-13 |
| 1407380587 | Karmen Adkins Neal | Counselor | 2574 74th Street, Suite 213, Lubbock, TX 79423 | 2017-04-17 |
| 1275992570 | Wal-mart Stores Texas, LLC | Technician/Technologist | 11415 Quaker Avenue, Lubbock, TX 79423 | 2016-02-15 |
| 1942679535 | Shena Smith | Psychologist | 2034 82nd St Unit 103, Lubbock, TX 79423 | 2015-09-24 |
| 1306263058 | Shelley Lee Ma, Lpc, PC | Counselor | 8200 Nahville, Suite 208, Lubbock, TX 79423 | 2014-03-19 |
| 1275893489 | Stacie Lynn Neffendorf | Speech-Language Pathologist | 3417 73rd St Ste N, Lubbock, TX 79423 | 2012-05-22 |
| 1932467230 | Debbie D Hearn | Point of Service | 8200 Nashville Ave. Suite #202, Lubbock, TX 79423 | 2012-04-25 |
| 1801163555 | Angel Laumbach-kirk | Occupational Therapist | 15304 County Road 2160, Lubbock, TX 79423 | 2011-11-23 |
| Find all providers in zip 79423 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962025296 | Amanda Kay Shelton | Counselor | 6202 Iola Ave Ste 111, Lubbock, TX 79424-2745 | 2020-05-20 |
| 1972148393 | Terri Beard | Counselor | 5701 Avenue P Bldg 9, Lubbock, TX 79412-3674 | 2019-11-08 |
| 1447764543 | Douglas Bradford Smith | Counselor | 8200 Nashville Ave Ste 203, Lubbock, TX 79423-1906 | 2017-11-28 |
| 1508394479 | Ann Keeling | Counselor | 519 N Kirby Ave, Lubbock, TX 79416-4088 | 2017-05-23 |
| 1881131332 | Michelle Tanner | Counselor | 5717 66th St Ste 131, Lubbock, TX 79424-1214 | 2017-01-23 |
| 1124436035 | Cody William Dickson | Counselor | 3805 22nd St Ste 1c, Lubbock, TX 79410-1142 | 2014-07-24 |
| 1790022044 | Ronald N Martin | Counselor | 5717 66th St, Suite 125, Lubbock, TX 79424-1223 | 2013-01-07 |
| 1063758407 | Shiloh Counseling Services, LLC | Counselor | 3602 Slide Rd Ste 32j, Lubbock, TX 79414-2549 | 2012-12-12 |
| 1144558792 | Kristi L Hosek | Counselor | 2032 82nd St, Ste 104, Lubbock, TX 79423-2398 | 2009-11-19 |
| 1891971826 | Richard Capodagli | Counselor | 3610 78th Dr, Lubbock, TX 79423-1222 | 2008-01-22 |
| Find all providers in LUBBOCK | ||||
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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.