MEDICARE: HANNAH BROOKS AMFT, APCC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1760056113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH BROOKS AMFT, APCC

Provider Business Mailing Address
First Line	:	1507 HENDRY CIR
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95765-4223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4125 TEMESCAL ST STE G
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-7558
Country	:	US
Telephone Number	:	916-619-7744
Fax Number	:

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

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	05/19/2021

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