MEDICARE: JANE BROOKS

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	101YP2500X	Professional Counselor	CTB20250866	NM

General Provider Information

NPI Number	:	1275063364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE BROOKS

Provider Business Mailing Address
First Line	:	7520 MONTGOMERY BLVD NE BLDG E15
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-1586
Country	:	US
Telephone Number	:	505-226-6380
Fax Number	:	505-214-5852

Provider Business Practice Location Address
First Line	:	1247 CENTRAL AVE STE F
Second Line	:	RM 207
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544
Country	:	US
Telephone Number	:	505-216-6381
Fax Number	:

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

Provider Enumeration Date	:	06/13/2017
Last Update Date	:	06/17/2026

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Directions to “ JANE BROOKS ” Practice Location

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