Brooke Coffey

Individual provider Active NPI Professional Counselor · Aztec, NM

NPI 1043691546 · NPPES record last updated Jun 1, 2023

Key facts

NPI
1043691546
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
.0015743 (CO)
Practice address
813 Road 2900
Aztec, NM 87410-9760
Phone
(484) 364-1503
Fax
(484) 364-1503
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75373

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
.0015743COMDProfessional Counselor

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Pennsylvania Counseling Services Inc. Past Accepting new patients
Pennsylvania Counseling Services Inc Past Accepting new patients

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X .0015743 CO Yes

Addresses

Primary practice location

813 Road 2900
Aztec, NM 87410-9760

Mailing address

813 Road 2900
Aztec, NM 87410-9760
Phone (484) 364-1503

Other providers in Aztec, NM

All providers in Aztec, NM · Professional Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.