Therese R Brooks, LMHC
Individual provider Active NPI Mental Health Counselor · Washougal, WA
NPI 1275913154 · NPPES record last updated Apr 12, 2018
Key facts
- NPI
- 1275913154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LH60803970 (WA)
- Practice address
- 303 N V St
Washougal, WA 98671-8538 - Phone
- (360) 909-9637
- NPI assigned
- Jun 4, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60803970 | WA | MD | Mental Health Counselor |
| MC60560661 | WA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60560661 | WA | |
| Mental Health Counselor | 101YM0800X | LH60803970 | WA | Yes |
Addresses
Primary practice location
303 N V St
Washougal, WA 98671-8538
Mailing address
1112 Daniels St Ste 40
Vancouver, WA 98660-2954
Phone (360) 909-9637
Other providers in Washougal, WA
- Lisa Bennett
- Elizabeth Bialkowsky
- Kristine Bingaman
- Anne Marie Bock
- Jennifer Elizabeth Bowen
- Ashley Buck
- Melanie Frances Budlong
- Alexis Leigh Bullard
- Andrea Nicole Bussey
- Heather A Cagle
All providers in Washougal, WA · Mental Health Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.