Provider Demographics
NPI:1427539956
Name:BROCK, MARGARET ARCHER (LMSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ARCHER
Last Name:BROCK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5307
Mailing Address - Country:US
Mailing Address - Phone:423-240-6323
Mailing Address - Fax:
Practice Address - Street 1:140 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-5307
Practice Address - Country:US
Practice Address - Phone:423-240-6323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801103247104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker