Provider Demographics
NPI:1184956872
Name:BROOKINS, RICHARD REGINALD (LPC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:REGINALD
Last Name:BROOKINS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:134 PREVATT RD
Mailing Address - Street 2:STE. 1
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-5427
Mailing Address - Country:US
Mailing Address - Phone:334-673-1668
Mailing Address - Fax:334-671-9199
Practice Address - Street 1:134 PREVATT RD
Practice Address - Street 2:STE. 1
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-5427
Practice Address - Country:US
Practice Address - Phone:334-673-1668
Practice Address - Fax:334-671-9199
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional