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1487227674 NPI number — TEENA LAVETTE BROOKS LCMHC, BC-TMH

NPI Number: 1487227674
Health Care Provider/Practitioner: TEENA LAVETTE BROOKS LCMHC, BC-TMH

Information about “1487227674” NPI (TEENA LAVETTE BROOKS LCMHC, BC-TMH) exists in 1487227674 in HTML format HTML  |  1487227674 in plain Text format TXT  |  1487227674 in PDF (Portable Document Format) PDF  |  1487227674 in an XML format XML  formats.

NPI Number : 1487227674 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487227674",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BROOKS",
    "FirstName": "TEENA",
    "MiddleName": "LAVETTE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCMHC, BC-TMH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STREETT",
    "OtherFirstName": "TEENA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1724 KNIGHTBRIDGE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEWTON",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28658-9305",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "828-244-9562",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2922 AUDREY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GASTONIA",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28054-7268",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "828-201-2496",
    "PracticeLocationAddressFaxNumber": "704-559-3445",
    "EnumerationDate": "07/23/2021",
    "LastUpdateDate": "07/23/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "13757",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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