Provider Demographics
NPI:1437486586
Name:BROOKS, EMILY (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 N MAIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3252
Mailing Address - Country:US
Mailing Address - Phone:802-321-3768
Mailing Address - Fax:
Practice Address - Street 1:65 N MAIN ST STE 8
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3252
Practice Address - Country:US
Practice Address - Phone:802-321-3768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT100.0057959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist