MEDICARE: BROOKE COOPER LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	03537	KS

General Provider Information

NPI Number	:	1023575073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE COOPER LCPC

Provider Business Mailing Address
First Line	:	PO BOX 144
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-0144
Country	:	US
Telephone Number	:	620-260-2962
Fax Number	:

Provider Business Practice Location Address
First Line	:	1604 SHORTHORN ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-4749
Country	:	US
Telephone Number	:	620-260-2962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	01/29/2026

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Directions to “ BROOKE COOPER LCPC” Practice Location

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