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General NPI Number Information
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NPI Number | 1396165767
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Entity Type | Individual
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Provider Name | BROOKS WITTER MA, LPC, LMHC
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Gender | Male
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 208 5TH ST STE 205
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City | AMES
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State | IA
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Zip | 50010-6259
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Country | US
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Telephone | 515-337-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 30628 DEER DR
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City | HUXLEY
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State | IA
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Zip | 50124-8067
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Country | US
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Telephone | 515-337-0335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5130
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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