Provider Demographics
NPI:1891825949
Name:BROOKS, JOHN ANDREW II (PSYD, PLLC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANDREW
Last Name:BROOKS
Suffix:II
Gender:M
Credentials:PSYD, PLLC
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:A
Other - Last Name:BROOKS
Other - Suffix:II
Other - Last Name Type:Other Name
Other - Credentials:PSYD, LPC
Mailing Address - Street 1:57 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-2069
Mailing Address - Country:US
Mailing Address - Phone:734-639-2262
Mailing Address - Fax:
Practice Address - Street 1:23 W 1ST ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-2332
Practice Address - Country:US
Practice Address - Phone:734-639-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional