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General NPI Number Information
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NPI Number | 1558426585
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Entity Type | Organization
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Legal Business Name | BROOKLEA COUNSELING & HEALTH SERVICES
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 900 E PARK BLVD SUITE 155
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City | PLANO
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State | TX
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Zip | 75074-5465
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Country | US
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Telephone | 214-883-1226
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Fax | 972-429-1901
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Provider Business Mailing Address
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Address Line | PO BOX 1481
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City | WYLIE
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State | TX
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Zip | 75098-1481
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Country | US
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Telephone | 214-883-1226
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Fax | 972-429-1901
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LENA BENTON
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Credential | LPC, RN
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Telephone | 214-883-1226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10294
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License Number State | TX
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