Healthcare Provider Details

I. General information

NPI: 1750611992
Provider Name (Legal Business Name): BROOK TAYLOR SPRAYBERRY LPC, MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 CREST DR
CHICKAMAUGA GA
30707-3207
US

IV. Provider business mailing address

911 CREST DR
CHICKAMAUGA GA
30707-3207
US

V. Phone/Fax

Practice location:
  • Phone: 423-599-0172
  • Fax: 423-599-0172
Mailing address:
  • Phone: 423-599-0172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2637
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: