Brooke Camden Widder, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

012114 Issued in GA

Practice address

2002 Macy Dr
Roswell, GA 30076-6346

Phone

(770) 765-5965

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Camden Counseling

  • Mental Health Counselor
  • Roswell, GA
  • NPI 1770449878
  NPD Authorized official

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1790354041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 MARIETTA HWY STE 630-245",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300756755",
            "telephone_number": "770-765-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766346",
            "telephone_number": "770-765-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDER",
        "first_name": "BROOKE",
        "middle_name": "CAMDEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "012114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deon Whitley, RBT
• Valjean McNeill Whitlow, PH.D.
• Heather Brooke Whittaker
• Collin Wesley Whitten, MT-BC
• Jessie Whyte
• Nicole Widjaja, DMD
• Caroline McLendon Wieler, MS, RDN
• Keonia Wiggins, MS
• Margaret Wilborn, FNP-C
• Betti Raydeen Wilburn

• Mental Health Counselor in Roswell, GA
• Providers in Roswell, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.