MEDICARE: MS. ERIKA NICOLE BROOKS LPC

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	0701003975	VA

General Provider Information

NPI Number	:	1760551782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIKA NICOLE BROOKS LPC

Provider Business Mailing Address
First Line	:	5412 GLENSIDE DR STE F
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-3995
Country	:	US
Telephone Number	:	804-282-5880
Fax Number	:	804-288-2029

Provider Business Practice Location Address
First Line	:	5412 GLENSIDE DR STE F
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-3995
Country	:	US
Telephone Number	:	804-282-5880
Fax Number	:	804-288-2029

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	09/27/2007

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