Provider Demographics
NPI:1447999487
Name:TINA BROOKS DBA CREATIVE COUNSELING
Entity type:Organization
Organization Name:TINA BROOKS DBA CREATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:YANKEY
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-230-7147
Mailing Address - Street 1:1405 GILMER AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-2321
Mailing Address - Country:US
Mailing Address - Phone:334-226-0971
Mailing Address - Fax:334-991-4171
Practice Address - Street 1:1405 GILMER AVE STE D
Practice Address - Street 2:
Practice Address - City:TALLASSEE
Practice Address - State:AL
Practice Address - Zip Code:36078-2321
Practice Address - Country:US
Practice Address - Phone:334-226-0971
Practice Address - Fax:334-991-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty