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NPI Code Detail

MEDICARE: BROOKE JUANITA GREATHOUSE

MEDICARE: BROOKE JUANITA GREATHOUSE
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 Counselor

General Provider Information

NPI Number : 1407785132
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE JUANITA GREATHOUSE
Provider Business Mailing Address
First Line : 8560 BROOKWAY CIR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99504-4270
Country : US
Telephone Number : 907-947-3471
Fax Number :
Provider Business Practice Location Address
First Line : 4600 DEBARR RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-3103
Country : US
Telephone Number : 907-222-7300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ BROOKE JUANITA GREATHOUSE ” Practice Location

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