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General NPI Number Information
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NPI Number | 1972897643
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Entity Type | Individual
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Provider Name | ALLENE MAXWELL BROOKS LPC, LISAC
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Gender | Female
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Dates
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Enumeration Date | 05/30/2011
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Last Update Date | 05/30/2011
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Provider Practice Location Address
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Address Line | 15270 W BROOKSIDE LN 121
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City | SURPRISE
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State | AZ
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Zip | 85374-2450
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Country | US
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Telephone | 480-226-6429
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Fax |
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Provider Business Mailing Address
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Address Line | 4541 W CONTINENTAL DR
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City | GLENDALE
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State | AZ
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Zip | 85308-3443
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Country | US
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Telephone | 480-226-6429
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1582
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12652
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License Number State | AZ
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