Provider Demographics
NPI:1245849421
Name:KNOWLES, BROOKE (LPC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 BURWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5216
Mailing Address - Country:US
Mailing Address - Phone:619-849-9318
Mailing Address - Fax:
Practice Address - Street 1:109 BURWOOD DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5216
Practice Address - Country:US
Practice Address - Phone:619-849-9318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7289101YM0800X
GALPC011279101YM0800X
FLMH15149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health