Provider Demographics
NPI:1326798356
Name:BROCKMAN, DIANNA (LPC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:BROCKMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 ARMOUR RD UNIT 7377
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-6206
Mailing Address - Country:US
Mailing Address - Phone:816-895-2876
Mailing Address - Fax:
Practice Address - Street 1:2106 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3426
Practice Address - Country:US
Practice Address - Phone:816-895-2876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC03520101YP2500X
MO2018036515101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional