Provider Demographics
NPI:1639655566
Name:LACHANCE, BROOKE (LCMHC, NCC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:LACHANCE
Suffix:
Gender:F
Credentials:LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 WATERSIDE CROSSING BLVD STE 2A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-3004
Mailing Address - Country:US
Mailing Address - Phone:704-360-3637
Mailing Address - Fax:704-625-9789
Practice Address - Street 1:7490 WATERSIDE CROSSING BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-3004
Practice Address - Country:US
Practice Address - Phone:704-360-3637
Practice Address - Fax:704-625-9789
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health