Provider Demographics
NPI:1902228059
Name:BROOKENS, LI (LCSW)
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:BROOKENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LI
Other - Middle Name:
Other - Last Name:BROOKENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2769 IRIS AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4405
Mailing Address - Country:US
Mailing Address - Phone:720-663-0163
Mailing Address - Fax:303-658-9871
Practice Address - Street 1:2769 IRIS AVE STE 118
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304
Practice Address - Country:US
Practice Address - Phone:720-663-0163
Practice Address - Fax:303-658-9871
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099233311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical