Provider Demographics
NPI:1235409798
Name:AKER, BROOKE N (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:N
Last Name:AKER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W ARCH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-1318
Mailing Address - Country:US
Mailing Address - Phone:260-726-8520
Mailing Address - Fax:260-726-8535
Practice Address - Street 1:603 W ARCH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-1318
Practice Address - Country:US
Practice Address - Phone:260-726-8520
Practice Address - Fax:260-726-8535
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002171A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health