Provider Demographics
NPI:1770751794
Name:BROOKS, JAIME JOLENE (PLMHP)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:JOLENE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80823
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68501-0823
Mailing Address - Country:US
Mailing Address - Phone:402-440-9051
Mailing Address - Fax:
Practice Address - Street 1:9040 TURNBERRY CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9233
Practice Address - Country:US
Practice Address - Phone:402-440-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8550OtherPLMHP