Provider Demographics
NPI:1205617677
Name:BROOKMAN, COURTNEY (LPC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BROOKMAN
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 1:733 THIMBLE SHOALS BLVD STE 170
Mailing Address - Street 2:OFFICE 128
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4260
Mailing Address - Country:US
Mailing Address - Phone:757-797-5192
Mailing Address - Fax:
Practice Address - Street 1:733 THIMBLE SHOALS BLVD
Practice Address - Street 2:STE 170 OFFICE 128
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-797-5192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012945101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health