Provider Demographics
NPI:1750831897
Name:BULL, BROOKE (LMFT)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:BULL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 WARD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2821
Mailing Address - Country:US
Mailing Address - Phone:505-440-8822
Mailing Address - Fax:
Practice Address - Street 1:48 WARD AVE
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2821
Practice Address - Country:US
Practice Address - Phone:505-440-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1558106H00000X
NH202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist