Provider Demographics
NPI:1912085291
Name:BROOKS, LINDSEY KATHERINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:KATHERINE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2702 CUNNINGHAM AVE
Mailing Address - Street 2:STE A
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1570
Mailing Address - Country:US
Mailing Address - Phone:417-782-1910
Mailing Address - Fax:417-782-1844
Practice Address - Street 1:2702 CUNNINGHAM AVE
Practice Address - Street 2:STE A
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1570
Practice Address - Country:US
Practice Address - Phone:417-782-1910
Practice Address - Fax:417-782-1844
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006031372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200098520AMedicaid
KS200671800AMedicaid
MO499411908Medicaid