Healthcare Provider Details

I. General information

NPI: 1417916248
Provider Name (Legal Business Name): BROOKE G DOOLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PALM BLVD STE 2A
ISLE OF PALMS SC
29451-2165
US

IV. Provider business mailing address

30 29TH AVE
ISLE OF PALMS SC
29451-2417
US

V. Phone/Fax

Practice location:
  • Phone: 843-270-8024
  • Fax:
Mailing address:
  • Phone: 843-270-8024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4590
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: