Provider Demographics
NPI:1356686869
Name:HARRIS, BROOKE E (LPC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:E
Last Name:HARRIS
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 1:2922 EVERGREEN PKWY STE 325
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7915
Mailing Address - Country:US
Mailing Address - Phone:720-504-7296
Mailing Address - Fax:
Practice Address - Street 1:2922 EVERGREEN PKWY STE 325
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7915
Practice Address - Country:US
Practice Address - Phone:720-504-7296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC003666101YM0800X
COLPC.0014334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health