Provider Demographics
NPI:1205614351
Name:BROOKS, KYMBERLIE SHERRI (LPC)
Entity type:Individual
Prefix:MRS
First Name:KYMBERLIE
Middle Name:SHERRI
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 N GAWAIN WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2889
Mailing Address - Country:US
Mailing Address - Phone:757-450-3554
Mailing Address - Fax:
Practice Address - Street 1:12 N GAWAIN WAY
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2889
Practice Address - Country:US
Practice Address - Phone:757-450-3554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012891101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional