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NPI Code Detail

MEDICARE: MS. BROOKE LYNN BENSON M.S., LPC, NCC

MEDICARE: MS. BROOKE LYNN BENSON M.S., LPC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1023100336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BROOKE LYNN BENSON M.S., LPC, NCC
Provider Business Mailing Address
First Line : 391 N HAYES ST
Second Line :
City : LARAMIE
State : WY
Zip : 82070-6244
Country : US
Telephone Number : 307-755-1866
Fax Number :
Provider Business Practice Location Address
First Line : 4989 N 3RD ST
Second Line :
City : LARAMIE
State : WY
Zip : 82072-9548
Country : US
Telephone Number : 307-745-8997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 06/09/2015

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