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1972897643 NPI number — ALLENE MAXWELL BROOKS LPC, LISAC

NPI Number: 1972897643
Health Care Provider/Practitioner: ALLENE MAXWELL BROOKS LPC, LISAC

Information about “1972897643” NPI (ALLENE MAXWELL BROOKS LPC, LISAC) exists in 1972897643 in HTML format HTML  |  1972897643 in plain Text format TXT  |  1972897643 in PDF (Portable Document Format) PDF  |  1972897643 in an XML format XML  formats.

NPI Number : 1972897643 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972897643",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BROOKS",
    "FirstName": "ALLENE",
    "MiddleName": "MAXWELL",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LPC, LISAC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BROOKS",
    "OtherFirstName": "GRACE",
    "OtherMiddleName": "M",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LPC, LISAC",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "4541 W CONTINENTAL DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLENDALE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85308-3443",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-226-6429",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15270 W BROOKSIDE LN",
    "SecondLinePracticeLocationAddress": "121",
    "PracticeLocationAddressCityName": "SURPRISE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85374-2450",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-226-6429",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/30/2011",
    "LastUpdateDate": "05/30/2011",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "1582",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "12652",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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