Provider Demographics
NPI:1669744355
Name:LANKFORD, BROOKE NICOLE (LPC, LPCS)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:NICOLE
Last Name:LANKFORD
Suffix:
Gender:F
Credentials:LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 BARBANNA RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN REST
Mailing Address - State:SC
Mailing Address - Zip Code:29664-9334
Mailing Address - Country:US
Mailing Address - Phone:864-710-5320
Mailing Address - Fax:
Practice Address - Street 1:208 FRONTAGE RD STE 1B
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1671
Practice Address - Country:US
Practice Address - Phone:864-633-0715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006522101YP2500X
SC5379101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional