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General NPI Number Information
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NPI Number | 1912818956
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Entity Type | Organization
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Legal Business Name | MY PAIN HIS PURPOSE MINISTRIES
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 2125 EXPRESS DR
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City | JACKSON
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State | TN
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Zip | 38305-6059
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Country | US
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Telephone | 970-430-6552
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Fax |
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Provider Business Mailing Address
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Address Line | 20 WHISPER CREEK DR
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City | JACKSON
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State | TN
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Zip | 38305-6106
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Country | US
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Telephone | 970-430-6552
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | HEATHER BROOKE
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Credential | LPC
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Telephone | 719-480-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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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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