Active NPI
Brian C Brooks
- Mental Health Counselor
- Eastport, ME
National Provider Identifier
1225223357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC11102
- Practice address
- 30 Boynton St
Eastport, ME 04631-1306 - Phone
- (207) 853-6001
- Fax
- (207) 853-6180
- NPI assigned
- Sep 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC11102 | ME | Primary |
Addresses
Primary practice location
30 Boynton St
Eastport, ME 04631-1306
Mailing address
30 Boynton St
Eastport, ME 04631-1306
Phone (207) 853-6001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC11102 | ME | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1225223357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BOYNTON ST",
"city": "EASTPORT",
"state": "ME",
"postal_code": "046311306",
"telephone_number": "207-853-6001",
"fax_number": "207-853-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 BOYNTON ST",
"city": "EASTPORT",
"state": "ME",
"postal_code": "046311306",
"telephone_number": "207-853-6001",
"fax_number": "207-853-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "BRIAN",
"middle_name": "C",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-11",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "MC11102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastport, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.