Provider Demographics
NPI:1700411337
Name:BROOKS, BRITTNEY (MA)
Entity Type:Individual
Prefix:MS
First Name:BRITTNEY
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N OAK PARK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1364
Mailing Address - Country:US
Mailing Address - Phone:314-250-7237
Mailing Address - Fax:
Practice Address - Street 1:105 N OAK PARK AVE FL 2
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1364
Practice Address - Country:US
Practice Address - Phone:314-250-7237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL2970Medicaid