Provider Demographics
NPI:1639650351
Name:HALL, BROOKE
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5928 REEDS ROAD
Mailing Address - Street 2:APARTMENT 300
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202
Mailing Address - Country:US
Mailing Address - Phone:816-984-8282
Mailing Address - Fax:
Practice Address - Street 1:5928 REEDS ROAD
Practice Address - Street 2:APARTMENT 300
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202
Practice Address - Country:US
Practice Address - Phone:816-984-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW067381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical