KELLY BROCK (NPI# 1588185060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588185060 |
| Entity Type | Individual |
| Full Name | KELLY BROCK |
| Credential | MSW |
| Practice Address |
470 Main St Mashpee MA 02649-2047 |
| Mailing Address |
1350 Keim St Crescent PA 15046-5447 |
| Practice Telephone | 5085212287 |
| Mailing Telephone | 5419127446 |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2017-07-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992324578 | Kelly Brock | Nutritionist | 1 Ireland Pl, Amityville, NY 11701-2955 | 2020-04-13 |
| 1730531047 | Kelly Brock | Behavioral Analyst | 35 Revere Rd, Queensbury, NY 12804-8044 | 2016-07-11 |
| 1558679837 | Kelly Brock | Pharmacist | 1312 Olwyn Dr, Tustin, CA 92780-3834 | 2010-09-20 |
| 1891971339 | Kelly Brock | Licensed Practical Nurse | 345 Elmwood Ter, Rochester, NY 14620-3707 | 2008-01-15 |
| 1184198871 | Kelly Brock | Occupational Therapist | 6700 France Ave S Ste 300, Edina, MN 55435-1908 | 2019-01-15 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1992100275 | Kelly Brock | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-1903 | 2014-10-28 |
| 1922438894 | Kelly Brock | Counselor | 77 E Merrimack St, Lowell, MA 01852-1251 | 2013-11-13 |
| 1316001134 | Kelly Koga Brock | Physical Therapist | 270 International Cir # Twon, Physical Therapy, San Jose, CA 95119-1130 | 2006-12-20 |
| Street Address |
470 MAIN ST |
| City | MASHPEE |
| State | MA |
| Zip Code | 02649-2047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356388466 | Arthur S Tenenbaum | Psychiatry & Neurology | 470 Main St, Mashpee, Mashpee, MA 02649-2047 | 2006-05-31 |
| 1548820293 | Norway Dolan | Community Health Worker | 470 Main St, Mashpee, MA 02649-2047 | 2019-06-15 |
| 1477010494 | Faith Savoy | Social Worker | 470 Main St, Mashpee, MA 02649-2047 | 2019-02-26 |
| 1265900187 | Enrico Michael Di Censo Jr. | Counselor | 470 Main St, Mashpee, MA 02649-2047 | 2018-11-08 |
| 1811462872 | Victoria Dominique Ward | Counselor | 470 Main St, Mashpee, MA 02649-2047 | 2018-10-05 |
| 1881182210 | James Thomas Murphy | Counselor | 470 Main St, Mashpee, MA 02649-2047 | 2018-05-01 |
| 1982119830 | Marybeth Ann Bernier | Community/Behavioral Health | 470 Main St, Mashpee, MA 02649-2047 | 2017-12-13 |
| 1235643636 | Deborah A. Thompson | Community/Behavioral Health | 470 Main St, Mashpee, MA 02649-2047 | 2017-11-21 |
| 1700395886 | Brittany Rae Sherman | Counselor | 470 Main St, Mashpee, MA 02649-2047 | 2017-09-21 |
| 1467972356 | Erika Pineda | Social Worker | 470 Main St, Mashpee, MA 02649-2047 | 2017-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457817348 | Emily Hannah Minakin | Physician Assistant | Community Health Center of Cape Cod, 107 Commercial Street, Mashpee, MA 02649 | 2019-02-15 |
| 1790278018 | Westwind Counseling & Wellness, LLC | Counselor | 681 Falmouth Rd Ste A20c, Mashpee, MA 02649 | 2018-06-11 |
| 1790151967 | Katie Justine Wallace | Nurse Practitioner | Mashpee Family Medicine 5 Industrial Drive, Suite 100, Mashpee, MA 02649 | 2015-08-11 |
| 1972847689 | Kara M Blackwell | Licensed Practical Nurse | 12 Pine Grove Circle, Mashpee, MA 02649 | 2012-11-19 |
| 1992001457 | Mashpee Service Unit/indian Health Service | Clinic/Center | 483 Great Neck Road South, Building 002-health Clinic, Mashpee, MA 02649 | 2011-02-01 |
| 1306178066 | Pamela W Brighton | Counselor | Mashpee Common 2 Oak St., Center for Family Therapy, Mashpee, MA 02649 | 2010-02-05 |
| 1063743524 | Shana M Truel | Counselor | 477 Main Street, Mashpee, MA 02649 | 2010-01-22 |
| 1376718197 | Christopher Joseph Salvo | Pediatrics | 107 Commercial St., Mashpee, MA 02649 | 2008-04-23 |
| 1215111489 | Joyce Teir Hosford | Speech-Language Pathologist | 418-88 Quinaquisset Ave., Mashpee, MA 02649 | 2007-12-24 |
| 1225218092 | Emily Davern | Social Worker | 107 Commerical St, Mashpee, MA 02649 | 2007-11-09 |
| Find all providers in zip 02649 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790844843 | Mashpee Mental Health Center, Inc. | Community/Behavioral Health | 400 Nathan Ellis Highway, Suite 1, Mashpee, MA 02649 | 2006-12-06 |
| 1982119830 | Marybeth Ann Bernier | Community/Behavioral Health | 470 Main St, Mashpee, MA 02649-2047 | 2017-12-13 |
| 1235643636 | Deborah A. Thompson | Community/Behavioral Health | 470 Main St, Mashpee, MA 02649-2047 | 2017-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132458 | Autism Behavioral & Therapeutic Services | Community/Behavioral Health | 5 Bedford Ave, Worcester, MA 01604-4707 | 2020-10-20 |
| 1508463811 | Clear Minded Care, Pllc | Community/Behavioral Health | 519 Somerville Ave # 291, Somerville, MA 02143-3347 | 2020-10-08 |
| 1316544455 | Barbara J Doyle Counseling Services Professional LLC | Community/Behavioral Health | 20 Hope Ave Ste 107, Waltham, MA 02453-2717 | 2020-10-01 |
| 1013524917 | Leonid G Zolotnitskiy Md PC | Community/Behavioral Health | 1853 Commonwealth Ave Ste 1, Brighton, MA 02135-5498 | 2020-09-25 |
| 1811502966 | R.e.s.t. Counseling Services, LLC | Community/Behavioral Health | 36 Tirrell St # 1, Worcester, MA 01603-2617 | 2020-09-14 |
| 1972118719 | Jose Alfredo Lugo-estrada | Community/Behavioral Health | 484 Bedford St Unit 2, East Bridgewater, MA 02333-1908 | 2020-09-09 |
| 1992318927 | Jessie Odegard Pllc | Community/Behavioral Health | 144 Sudbury Rd, Weston, MA 02493-1351 | 2020-08-28 |
| 1750994109 | Summit Community Services, LLC | Community/Behavioral Health | 214 Exchange St, Millis, MA 02054-1277 | 2020-08-26 |
| 1013527860 | Tara Goldberg | Community/Behavioral Health | 21 Wilson Ave, Northampton, MA 01060-3813 | 2020-08-06 |
| 1619587490 | Maat Therapeutic Solutions Inc. | Community/Behavioral Health | 1773 Dorchester Ave Ste 3, Boston, MA 02124-2556 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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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.