Provider Demographics
NPI:1497204044
Name:BROOKS, BRENDA (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 HIGHWAY 7 STE 200
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3955
Mailing Address - Country:US
Mailing Address - Phone:952-562-5743
Mailing Address - Fax:
Practice Address - Street 1:8800 HIGHWAY 7 STE 200
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3955
Practice Address - Country:US
Practice Address - Phone:952-562-5743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health