MEDICARE: BROOKE KNOWLES LPC

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
1	101YM0800X	Mental Health Counselor	7289	SC
2	101YP2500X	Professional Counselor	7289	SC
3	101YP2500X	Professional Counselor	LPC011279	GA
4	101YM0800X	Mental Health Counselor	MH15149	FL
5	101YM0800X	Mental Health Counselor	LMHC10000216	MA
6	101YP2500X	Professional Counselor	MH15149	FL
7	101YM0800X	Mental Health Counselor	LPC011279	GA
8	101YP2500X	Professional Counselor	LMHC10000216	MA

General Provider Information

NPI Number	:	1245849421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE KNOWLES LPC

Provider Business Mailing Address
First Line	:	1317 EDGEWATER DR # 379
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	813-803-1718
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 EDGEWATER DR # 379
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	813-803-1718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2020
Last Update Date	:	12/12/2025

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Directions to “ BROOKE KNOWLES LPC” Practice Location

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