Provider Demographics
NPI:1003914805
Name:BROOKS, KAREN S (LLP, CACII)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LLP, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30592 SABRINA CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-1252
Mailing Address - Country:US
Mailing Address - Phone:888-802-7472
Mailing Address - Fax:810-392-3385
Practice Address - Street 1:400 STODDARD RD.
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:MI
Practice Address - Zip Code:48041-1038
Practice Address - Country:US
Practice Address - Phone:810-392-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI500044101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)