Brock, James Vaughn

Brock, James Vaughn is an sole proprietor health care provider with primary practice located at Dougherty Counseling Center 1919 State St., Ste. #2, New Albany IN 47150. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Brock, James Vaughn can be contacted via phone (812) 944-2532.

Contact Information

Primary practice address
Dougherty Counseling Center 1919 State St., Ste. #2 New Albany IN 47150
Phone: (812) 944-2532
Fax: (812) 944-2549
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 33001554A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2009-100 Kentucky

Profile Details

NPI number 1750485850
LBN Legal business name Brock, James Vaughn
Credentials MDIV., PSYD., L.S.W.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2006
Last updated Feb 1st, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750485850 NPPES
Indiana Other 11438111 CAQH PROVIDER #

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