Healthcare Provider Details

I. General information

NPI: 1942139613
Provider Name (Legal Business Name): BROOKLYNN MARIE WAY TLMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROOKLYNN MARIE OSCARSON TLMHC

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 NW 114TH ST
CLIVE IA
50325-7030
US

IV. Provider business mailing address

5517 NE LAVENDER LN
ANKENY IA
50021-6243
US

V. Phone/Fax

Practice location:
  • Phone: 515-949-6918
  • Fax:
Mailing address:
  • Phone: 515-612-2393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number136575
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: