Provider Demographics
NPI:1801478128
Name:URICH, BROOKE NICOLE (MS, LPC-T, MHSP-T)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:NICOLE
Last Name:URICH
Suffix:
Gender:F
Credentials:MS, LPC-T, MHSP-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 FRANKLIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-8214
Mailing Address - Country:US
Mailing Address - Phone:417-300-2602
Mailing Address - Fax:
Practice Address - Street 1:574 FRANKLIN RD STE 200
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-8214
Practice Address - Country:US
Practice Address - Phone:417-300-2602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health