Lori Brookhart

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.1300082 Issued in OH

Practice address

1458 Yankee Park PL
Suite P
Dayton, OH 45458-1959

Phone

(937) 952-5011

NPI assigned

Dec 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Healing Epiphany Innovative Supportive Treatment

  • Professional Counselor
  • Englewood, OH
  • NPI 1245025279
  NPD Authorized official

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1982148730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 YANKEE PARK PL",
            "address_2": "SUITE P",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581959",
            "telephone_number": "937-952-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 YANKEE PARK PL",
            "address_2": "SUITE P",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581959",
            "telephone_number": "937-952-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKHART",
        "first_name": "LORI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.111003",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1300082",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0800395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Brondon, DPM
• Michael Brondon
• Nikeeta Bronston, CDCA
• Brookdale Senior Living Communities Inc
• Brooke'S Gift of Love Homecare LLC
• Seth Anthony Brookhart
• Tashana Michelle Brookins
• Clororessea Brooks Garrett
• Virginia Lee Brooks-Kuwamoto, HOME HEALTH AIDE
• Ashley Brooks

• Mental Health Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.