Doc NPI

1174853220

Everything you always wanted to know about BROCKMANN KEITH SCOTT LMHC but were afraid to ask.

BROCKMANN KEITH SCOTT LMHC

You can also download the this 1174853220 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
BROCKMANN KEITH SCOTT LMHC
Gender:
Male
Enumeration date:
2010-01-12
Last update date:
2010-01-12
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
101Y00000X Counselor IA 00438 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 5159934535
Practice Location Address Telephone Number 5159934535
Mailing Address Fax Number 5159933845
Practice Location Address Fax Number 5159933845

Addresses

Type Address City State Postal Country
Mailing Address 2111 W. GREENE ST. ADEL IA 50003 IA
Practice Location Address 2111 W. GREENE ST. ADEL IA 50003 IA

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NPI Name Address State City
1043515687 HANSEN, ALICE
Individual		 2111 GREENE ST IA ADEL
1316029705 WEST CENTRAL MENTAL HEALTH CEN
Organization		 2111 W GREEN ST IA ADEL
1790015840 CARROLL, PAULA
Individual		 2111 W. GREENE ST. IA ADEL

Other NPI Records that share an address

NPI Name Address State City
1790015840 CARROLL, PAULA
Individual		 2111 W. GREENE ST. IA ADEL