Provider Demographics
NPI:1336459411
Name:KINTONIS BROOKS, HELEN (LPCC)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:
Last Name:KINTONIS BROOKS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:KINTONIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:PO BOX 8244
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88202-8244
Mailing Address - Country:US
Mailing Address - Phone:575-624-2095
Mailing Address - Fax:575-208-0780
Practice Address - Street 1:106 E LINDA VISTA BLVD STE 104
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5905
Practice Address - Country:US
Practice Address - Phone:480-599-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0143171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN0015054Medicaid
NM03838528Medicaid