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General NPI Number Information
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NPI Number | 1659524254
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Entity Type | Individual
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Provider Name | CEIT AQUIN BROOKS LPC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 305 W 16TH ST
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City | VANCOUVER
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State | WA
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Zip | 98660-2791
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Country | US
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Telephone | 360-989-7519
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 131
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City | VANCOUVER
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State | WA
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Zip | 98666-0131
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Country | US
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Telephone | 360-989-7519
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Fax | 360-546-5554
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH 60022770
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License Number State | WA
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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 | C2154
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License Number State | OR
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