Provider Demographics
NPI:1992026314
Name:BLEAU, BROOKE M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:M
Last Name:BLEAU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1310 E ARLINGTON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5931
Mailing Address - Country:US
Mailing Address - Phone:252-321-6306
Mailing Address - Fax:252-355-3689
Practice Address - Street 1:1310 E ARLINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5931
Practice Address - Country:US
Practice Address - Phone:252-321-6306
Practice Address - Fax:252-355-3689
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC7913101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional