Healthcare Provider Details

I. General information

NPI: 1649681024
Provider Name (Legal Business Name): BROOKE DUDINE M.S, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE NELMS LPC

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9741 PRESTON RD STE 208
FRISCO TX
75033-2554
US

IV. Provider business mailing address

7830 VAN TUYL PKWY APT 422
MCKINNEY TX
75070-1949
US

V. Phone/Fax

Practice location:
  • Phone: 972-943-0500
  • Fax:
Mailing address:
  • Phone: 469-592-1673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number82952
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: