Provider Demographics
NPI:1144795139
Name:BROOKS-PRIM, LACHANDRA MONET (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LACHANDRA
Middle Name:MONET
Last Name:BROOKS-PRIM
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 1:6212 TENNYSON DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-4335
Mailing Address - Country:US
Mailing Address - Phone:334-220-5889
Mailing Address - Fax:
Practice Address - Street 1:6212 TENNYSON DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-4335
Practice Address - Country:US
Practice Address - Phone:334-220-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4227101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor