Healthcare Provider Details

I. General information

NPI: 1245472182
Provider Name (Legal Business Name): TARA ANNETTE BROOKS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA A HAMILTON

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 COLLEGE ST SE
LACEY WA
98503-4389
US

IV. Provider business mailing address

1776 SW MADISON ST
PORTLAND OR
97205-1715
US

V. Phone/Fax

Practice location:
  • Phone: 360-456-7575
  • Fax: 360-493-5088
Mailing address:
  • Phone: 503-224-1044
  • Fax: 503-621-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH70011066
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: