Provider Demographics
NPI:1003451329
Name:RADECH, BROOKE HALL ALLENDER (TLMHC, NCC, SCHOOLCO)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:HALL ALLENDER
Last Name:RADECH
Suffix:
Gender:F
Credentials:TLMHC, NCC, SCHOOLCO
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:HALL
Other - Last Name:ALLENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27011 151ST AVE
Mailing Address - Street 2:
Mailing Address - City:LONG GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:52756-8719
Mailing Address - Country:US
Mailing Address - Phone:563-468-3333
Mailing Address - Fax:
Practice Address - Street 1:3625 UTICA RIDGE RD STE F
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1653
Practice Address - Country:US
Practice Address - Phone:563-359-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty