Provider Demographics
NPI:1659524254
Name:AQUIN BROOKS, CEIT (LPC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:CEIT
Middle Name:
Last Name:AQUIN BROOKS
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-0131
Mailing Address - Country:US
Mailing Address - Phone:360-989-7519
Mailing Address - Fax:360-546-5554
Practice Address - Street 1:305 W 16TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2791
Practice Address - Country:US
Practice Address - Phone:360-989-7519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60022770101YM0800X
ORC2154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health