Provider Demographics
NPI:1942548409
Name:LEIRD, BROOKE S (MS, LPC, LCDC)
Entity Type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:S
Last Name:LEIRD
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 MEDICAL CTR DR
Mailing Address - Street 2:UNIT 3A
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4817 MEDICAL CENTER DR
Practice Address - Street 2:UNIT 3A
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1886
Practice Address - Country:US
Practice Address - Phone:972-607-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11583101YA0400X
TX65941101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)