Provider Demographics
NPI:1669855425
Name:COOK, BROOKLYN ELISE (CMHC, NCC)
Entity type:Individual
Prefix:DR
First Name:BROOKLYN
Middle Name:ELISE
Last Name:COOK
Suffix:
Gender:F
Credentials:CMHC, NCC
Other - Prefix:
Other - First Name:BROOKLYN
Other - Middle Name:ELISE
Other - Last Name:REBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:296 W 100 S
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2116
Mailing Address - Country:US
Mailing Address - Phone:678-860-0233
Mailing Address - Fax:
Practice Address - Street 1:296 W 100 S
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2116
Practice Address - Country:US
Practice Address - Phone:678-860-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11793386-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health