Provider Demographics
NPI:1669106605
Name:DEASE, BROOKLYNN HAAS (NCC, LCMHCA, MA)
Entity type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:HAAS
Last Name:DEASE
Suffix:
Gender:F
Credentials:NCC, LCMHCA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16325 NORTHCROSS DR STE F
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5044
Mailing Address - Country:US
Mailing Address - Phone:704-237-4240
Mailing Address - Fax:
Practice Address - Street 1:16325 NORTHCROSS DR STE F
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5044
Practice Address - Country:US
Practice Address - Phone:704-237-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health