MEDICARE: STEPHANIE BROOKINS LPC LLC

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	LPC004854	GA

General Provider Information

NPI Number	:	1619429446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHANIE BROOKINS LPC LLC

Provider Business Mailing Address
First Line	:	4 BRADLEY PARK CT STE 1B
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3636
Country	:	US
Telephone Number	:	706-322-7911
Fax Number	:	706-327-1444

Provider Business Practice Location Address
First Line	:	4 BRADLEY PARK CT STE 1B
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3636
Country	:	US
Telephone Number	:	706-322-7911
Fax Number	:	706-327-1444

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MRS. STEPHANIE MARIE BROOKINS
Credential	:	MS, LPC
Telephone Number	:	706-322-7911

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	06/02/2026

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