MEDICARE: BROOKE PAULSON AHERNE LCPC

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	LC9274	SC

General Provider Information

NPI Number	:	1396402095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE PAULSON AHERNE LCPC

Provider Business Mailing Address
First Line	:	54 SATURDAY RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-2695
Country	:	US
Telephone Number	:	843-793-7285
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 SATURDAY RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-2695
Country	:	US
Telephone Number	:	843-793-7285
Fax Number	:

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

Provider Enumeration Date	:	11/17/2021
Last Update Date	:	03/05/2026

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