Provider Demographics
NPI:1871274977
Name:BROOKS, JENNIFER J (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16500 SAN PEDRO AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2253
Mailing Address - Country:US
Mailing Address - Phone:210-845-8544
Mailing Address - Fax:
Practice Address - Street 1:16500 SAN PEDRO AVE STE 215
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2253
Practice Address - Country:US
Practice Address - Phone:210-845-8544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health