Provider Demographics
NPI:1700320249
Name:BROOKS, CHELSEY (LPC)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26029 HUNTWICK GLEN SQ # QU
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5716
Mailing Address - Country:US
Mailing Address - Phone:518-573-9007
Mailing Address - Fax:
Practice Address - Street 1:19441 GOLF VISTA PLZ
Practice Address - Street 2:SUITE 110
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8269
Practice Address - Country:US
Practice Address - Phone:518-573-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional