Provider Demographics
NPI:1568607836
Name:BROOKS, TONY PAUL (MA, LIMHP)
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:PAUL
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MA, LIMHP
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:PAUL
Other - Last Name:LINDQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2444 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1125
Mailing Address - Country:US
Mailing Address - Phone:402-475-7666
Mailing Address - Fax:402-476-9623
Practice Address - Street 1:2444 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1125
Practice Address - Country:US
Practice Address - Phone:402-475-7666
Practice Address - Fax:402-476-9623
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47039881900Medicaid
NE$$$$$$$$$Medicaid