Provider Demographics
NPI:1558475707
Name:BROOKS, JEANNE D (PHD)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:D
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 LINKHORNE DR STE D
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-3353
Mailing Address - Country:US
Mailing Address - Phone:434-582-9061
Mailing Address - Fax:434-616-3115
Practice Address - Street 1:2811 LINKHORNE DR STE D
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-3353
Practice Address - Country:US
Practice Address - Phone:434-582-9061
Practice Address - Fax:434-616-3115
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5153101YA0400X
TX13557101YM0800X
VA0701004497101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health