Provider Demographics
NPI:1679064885
Name:BROOKS, AMBER BEVERLY
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:BEVERLY
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 MUD TURTLE POND RD
Mailing Address - Street 2:
Mailing Address - City:ORFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03777-4713
Mailing Address - Country:US
Mailing Address - Phone:603-726-1225
Mailing Address - Fax:
Practice Address - Street 1:228 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5500
Practice Address - Country:US
Practice Address - Phone:603-622-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)