MEDICARE: SUNSHINE BROOKE ALEXANDER

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	LPCC.0017260	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LPCC.0017260	OTHER	CO	LPCC LICENSE NUMBER

General Provider Information

NPI Number	:	1992387328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNSHINE BROOKE ALEXANDER

Provider Business Mailing Address
First Line	:	5585 ERINDALE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6737
Country	:	US
Telephone Number	:	719-345-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	4245 CENTENNIAL BLVD. SUITE 205
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919
Country	:	US
Telephone Number	:	719-345-2424
Fax Number	:

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

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	04/26/2021

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Directions to “ SUNSHINE BROOKE ALEXANDER ” Practice Location

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