Provider Demographics
NPI:1578309381
Name:BROOKS, AMANDA NOELLE (LPCC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NOELLE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CLIFTY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-1710
Mailing Address - Country:US
Mailing Address - Phone:606-678-0026
Mailing Address - Fax:
Practice Address - Street 1:600 CLIFTY ST STE 2
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1710
Practice Address - Country:US
Practice Address - Phone:606-678-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY293263101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health