Individual provider Active NPI

Stephanie Renee Brooks, MS, LPC, NCC

  • Mental Health Counselor
  • Lebanon, IN
National Provider Identifier
1740481464
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C3010 Issued in OR
Practice address
940 Lasley Dr
Lebanon, IN 46052-1480
Phone
(888) 714-1927
NPI assigned
May 30, 2007
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2007025728 MO
Mental Health Counselor 101YM0800X IN
Mental Health Counselor 101YM0800X 8515 NC
Mental Health Counselor 101YM0800X 61921 TX
Mental Health Counselor 101YM0800X C3010 OR Primary

Addresses

Primary practice location

940 Lasley Dr
Lebanon, IN 46052-1480

Mailing address

940 Lasley Dr
Lebanon, IN 46052-1480
Phone (888) 714-1927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213003538 IN Practitioner - Mental Health Counselor 4880043009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cummins Behavioral Health Systems IncorporatedGroup PAC ID 1850296302, 18 clinicians

Practice addresses (Care Compare)

6655 E US Hwy 36
Avon, IN 46123-8923
Phone (888) 714-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2007025728MOMDCounselor
C3010ORMDMental Health Counselor
61921TXMDMental Health Counselor
8515NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cummins Behavioral Health Systems, Incorporated CurrentSince Jan 1, 2024 Accepting new patients

Locations

5101 E US Highway 36
Ste 100
Avon, IN 46123
Phone (317) 745-9555

6655 E US Highway 36
Avon, IN 46123
Phone (317) 272-3330

1540 Darlington Ave
Crawfordsville, IN 47933

308 Medic Way
Greencastle, IN 46135
Phone (317) 653-2669

5638 Professional Cir
Indianapolis, IN 46241
Phone (317) 247-8900

940 Lasley Dr
Lebanon, IN 46052
Phone (765) 482-7421

Organizations & group practices 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1740481464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 LASLEY DR",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521480",
            "telephone_number": "888-714-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 LASLEY DR",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521480",
            "telephone_number": "888-714-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2007025728",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8515",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "61921",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, IN

Sources for this page

Verify at the official NPI Registry.