Healthcare Provider Details

I. General information

NPI: 1598697278
Provider Name (Legal Business Name): BROOK KNOWLTON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 FRANKLIN AVE STE 403
BERLIN MD
21811-1263
US

IV. Provider business mailing address

314 FRANKLIN AVE STE 403
BERLIN MD
21811-1263
US

V. Phone/Fax

Practice location:
  • Phone: 410-812-4405
  • Fax: 443-782-0350
Mailing address:
  • Phone: 410-812-4405
  • Fax: 443-782-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC17962
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: