Provider Demographics
NPI:1073250049
Name:TOUSLEY, BROOKE LYNN (LCSW INTERN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:LYNN
Last Name:TOUSLEY
Suffix:
Gender:F
Credentials:LCSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 SARAH BETH LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1039
Mailing Address - Country:US
Mailing Address - Phone:775-440-7098
Mailing Address - Fax:
Practice Address - Street 1:4655 SARAH BETH LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-1039
Practice Address - Country:US
Practice Address - Phone:775-440-7098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-18781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical