Provider Demographics
NPI:1184276149
Name:STEIN, BROOKE (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:MICHELLE
Other - Last Name:EGLOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC
Mailing Address - Street 1:24302 LIPPERT RD
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-9172
Mailing Address - Country:US
Mailing Address - Phone:814-873-8957
Mailing Address - Fax:
Practice Address - Street 1:435 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4404
Practice Address - Country:US
Practice Address - Phone:814-807-0861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011448101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional