Active NPI
Brooke Martin LPC PLLC
- Community/Behavioral Health Agency
- Bryan, TX
National Provider Identifier
1972970531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 67067
- Legal business name
- BROOKE MARTIN LPC PLLC
- Practice address
- 3201 University Dr E
Suite 200
Bryan, TX 77802-3475 - Phone
- (979) 229-4203
- Fax
- (844) 388-6134
- NPI assigned
- Aug 29, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brooke Martin
- Title
- Licensed Professional Counselor
- Phone
- (979) 571-6648
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 67067 | TX | Primary |
Addresses
Primary practice location
3201 University Dr E
Suite 200
Bryan, TX 77802-3475
Mailing address
3201 University Dr E
Suite 200
Bryan, TX 77802-3475
Phone (979) 229-4203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598106221 | Medicaid | TX |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1440806400000",
"number": "1972970531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 UNIVERSITY DR E",
"address_2": "SUITE 200",
"city": "BRYAN",
"state": "TX",
"postal_code": "778023475",
"telephone_number": "979-229-4203",
"fax_number": "844-388-6134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 UNIVERSITY DR E",
"address_2": "SUITE 200",
"city": "BRYAN",
"state": "TX",
"postal_code": "778023475",
"telephone_number": "979-229-4203",
"fax_number": "844-388-6134"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BROOKE MARTIN LPC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-29",
"last_updated": "2015-08-29",
"status": "A",
"authorized_official_last_name": "MARTIN",
"authorized_official_first_name": "BROOKE",
"authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
"authorized_official_telephone_number": "979-571-6648"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "TX",
"license": "67067",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1598106221",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.