Active NPI
Therese R Brooks, LMHC
- Mental Health Counselor
- Washougal, WA
National Provider Identifier
1275913154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60803970
- Practice address
- 303 N V St
Washougal, WA 98671-8538 - Phone
- (360) 909-9637
- NPI assigned
- Jun 4, 2015
- Last updated
- Apr 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60560661 | WA | |
| Mental Health Counselor | 101YM0800X | LH60803970 | WA | Primary |
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
Medicare participation
Medicare enrollment files- 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
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60803970 | WA | MD | Mental Health Counselor |
| MC60560661 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523491200000",
"number": "1275913154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 DANIELS ST STE 40",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986602954",
"telephone_number": "360-909-9637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N V ST",
"city": "WASHOUGAL",
"state": "WA",
"postal_code": "986718538",
"telephone_number": "360-909-9637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "THERESE",
"middle_name": "R",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-04",
"last_updated": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60560661",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60803970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washougal, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.