Organization
BROCK FAMILY THERAPY CENTER INC.
Active
Organization
BROCK FAMILY THERAPY CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA C BROCK LCSW, LMFT, MBA (PRINCIPAL THERAPIST/OWNER)
(502) 785-4322
Entity
Organization
Contact information
Practice address
10300 BROOKRIDGE VILLAGE BLVD, SUITE 104, LOUISVILLE, KY 40291
(502) 785-4322
(502) 785-4433
Mailing address
10300 BROOKRIDGE VILLAGE BLVD, SUITE 104, LOUISVILLE, KY 40291
(502) 785-4322
(502) 785-4433
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
3035
KY
261QM0850X
Adult Mental Health Clinic/Center
Primary
0617
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100068240
—
KY
Enumeration date
07/16/2015
Last updated
08/21/2023
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