Individual
ROBERT TRAVIS BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LMHP, PLADC, LPC
Contact information
Practice address
1709 JACKSON ST, OMAHA, NE 68102-2513
(402) 599-2550
(402) 599-2565
Mailing address
6249 PONDEROSA CIR, OMAHA, NE 68137-4277
(402) 895-1747
(402) 599-2564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1258
NE
101YM0800X
Mental Health Counselor
Primary
4384
NE
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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