Provider Demographics
NPI:1952540304
Name:BROOKS, LONNA JOAN (MA,LPC)
Entity Type:Individual
Prefix:MRS
First Name:LONNA
Middle Name:JOAN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S WASHITA AVE
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:OK
Mailing Address - Zip Code:73098-7820
Mailing Address - Country:US
Mailing Address - Phone:405-665-4385
Mailing Address - Fax:405-665-6396
Practice Address - Street 1:202 S WASHITA AVE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:OK
Practice Address - Zip Code:73098-7820
Practice Address - Country:US
Practice Address - Phone:405-665-4385
Practice Address - Fax:405-665-6396
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100749080AMedicaid
OK100749080CMedicaid