Provider Demographics
NPI:1851825418
Name:MARCHANT, BROOKE MCKAY (MA)
Entity Type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:MCKAY
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:MCKAY
Other - Last Name:MARCHANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:3175 W FLOYD AVE APT D203
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-7236
Mailing Address - Country:US
Mailing Address - Phone:307-286-6425
Mailing Address - Fax:
Practice Address - Street 1:7220 W JEFFERSON AVE STE 202
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2023
Practice Address - Country:US
Practice Address - Phone:719-375-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0017713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty