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NPI Code Detail

MEDICARE: BROOKE BROCKMAN MA, LPC, NCC

MEDICARE:   BROOKE  BROCKMAN  MA, LPC, NCC
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 Counselor86704TX

General Provider Information

NPI Number : 1528761079
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE BROCKMAN MA, LPC, NCC
Provider Business Mailing Address
First Line : 1716 CONSTANTINO CIR UNIT B
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4171
Country : US
Telephone Number : 469-671-1709
Fax Number :
Provider Business Practice Location Address
First Line : 1716 CONSTANTINO CIR UNIT B
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4171
Country : US
Telephone Number : 469-671-1709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2023
Last Update Date : 03/23/2023

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Directions to “ BROOKE BROCKMAN MA, LPC, NCC” Practice Location

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