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NPI Code Detail

MEDICARE: JENNY VAN OVERBEKE BROOKS, PH.D., P.C.

MEDICARE: JENNY VAN OVERBEKE BROOKS, PH.D., P.C.
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
1251S00000XCommunity/Behavioral Health AgencyPSY003048GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407003536
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNY VAN OVERBEKE BROOKS, PH.D., P.C.
Provider Business Mailing Address
First Line : 4045 ORCHARD RD SE STE 110
Second Line :
City : SMYRNA
State : GA
Zip : 30080-4904
Country : US
Telephone Number : 770-293-1950
Fax Number : 770-293-1955
Provider Business Practice Location Address
First Line : 4045 ORCHARD RD SE STE 110
Second Line :
City : SMYRNA
State : GA
Zip : 30080-4904
Country : US
Telephone Number : 770-293-1950
Fax Number : 770-293-1955
Authorized Official
Title or Position : OWNER/PSYCHOLOGIST
Name : DR. JENNY VAN OVERBEKE BROOKS
Credential : PH.D.
Telephone Number : 770-293-1950
Provider Enumeration Date : 08/20/2008
Last Update Date : 01/29/2020

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