Provider Demographics
NPI:1902563752
Name:LANDS, BROOKE ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:LANDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6407 JARMON RD UNIT 100
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-9342
Mailing Address - Country:US
Mailing Address - Phone:256-673-8277
Mailing Address - Fax:
Practice Address - Street 1:3595 E FOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-1733
Practice Address - Country:US
Practice Address - Phone:719-623-7190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6651G101Y00000X
CO0009926330101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor