Healthcare Provider Details

I. General information

NPI: 1336459411
Provider Name (Legal Business Name): HELEN KINTONIS BROOKS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HELEN KINTONIS LPCC

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E LINDA VISTA BLVD STE 104
ROSWELL NM
88201-5905
US

IV. Provider business mailing address

PO BOX 8244
ROSWELL NM
88202-8244
US

V. Phone/Fax

Practice location:
  • Phone: 480-599-8745
  • Fax:
Mailing address:
  • Phone: 575-624-2095
  • Fax: 575-208-0780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0143171
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: