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NPI Code Detail

MEDICARE: BROOKE TENILLE MCMILLIN MFTC, LPCC

MEDICARE: BROOKE TENILLE MCMILLIN MFTC, LPCC
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
1101YM0800XMental Health CounselorLPCC.0022728CO
2106H00000XMarriage & Family TherapistMFTC.0014724CO

General Provider Information

NPI Number : 1215882527
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE TENILLE MCMILLIN MFTC, LPCC
Provider Business Mailing Address
First Line : 4287 BAYS WATER DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-7633
Country : US
Telephone Number : 785-224-7494
Fax Number :
Provider Business Practice Location Address
First Line : 6710 S US HIGHWAY 85-87
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1014
Country : US
Telephone Number : 719-388-3558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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