Healthcare Provider Details

I. General information

NPI: 1669962957
Provider Name (Legal Business Name): BROOKE A O'GARA LMHC, LCDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MENDON RD STE E-500
CUMBERLAND RI
02864-4391
US

IV. Provider business mailing address

1800 MENDON RD STE E-500
CUMBERLAND RI
02864-4391
US

V. Phone/Fax

Practice location:
  • Phone: 401-439-4835
  • Fax: 401-574-2015
Mailing address:
  • Phone: 401-439-4835
  • Fax: 401-574-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01251
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP00810
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: