Provider Demographics
NPI:1083502223
Name:BORROWMAN, BROOKE A
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:A
Last Name:BORROWMAN
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 1:310 W 5TH SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:IL
Mailing Address - Zip Code:62069-1912
Mailing Address - Country:US
Mailing Address - Phone:217-313-3607
Mailing Address - Fax:
Practice Address - Street 1:310 W 5TH SOUTH ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:IL
Practice Address - Zip Code:62069-1912
Practice Address - Country:US
Practice Address - Phone:217-313-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor