Provider Demographics
NPI:1235743253
Name:LANIGAN, BROOKE LAWRENCE
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:LAWRENCE
Last Name:LANIGAN
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 1:1780 S BELLAIRE ST STE 270
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4470
Mailing Address - Country:US
Mailing Address - Phone:720-815-6659
Mailing Address - Fax:
Practice Address - Street 1:1780 S BELLAIRE ST STE 270
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4470
Practice Address - Country:US
Practice Address - Phone:720-815-6659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSYC.00015495103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical