Healthcare Provider Details

I. General information

NPI: 1326903378
Provider Name (Legal Business Name): EVA AVERIE BROOKIE LMHC, LPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

296 SW COLUMBIA ST STE A
BEND OR
97702-1020
US

IV. Provider business mailing address

1116 NW PORTLAND AVE APT 1A
BEND OR
97703-1689
US

V. Phone/Fax

Practice location:
  • Phone: 541-633-4591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61458383
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC11056
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: