Provider Demographics
NPI:1780937292
Name:AGGELER, BROOKE LYNN (MSC, LPC)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:LYNN
Last Name:AGGELER
Suffix:
Gender:F
Credentials:MSC, LPC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:LYNN
Other - Last Name:ROCKWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSC, LLPC
Mailing Address - Street 1:1101 BALL AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-5904
Mailing Address - Country:US
Mailing Address - Phone:616-456-6571
Mailing Address - Fax:616-456-8568
Practice Address - Street 1:1101 BALL AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-5904
Practice Address - Country:US
Practice Address - Phone:616-456-6571
Practice Address - Fax:616-456-8568
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MI6401013416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor