Provider Demographics
NPI:1982465258
Name:MILLER, BROOKE JEAN (CADC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S GIBSON RD APT 6208
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2687
Mailing Address - Country:US
Mailing Address - Phone:775-267-7236
Mailing Address - Fax:
Practice Address - Street 1:3050 E DESERT INN RD STE 116
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3872
Practice Address - Country:US
Practice Address - Phone:702-796-0660
Practice Address - Fax:702-796-1835
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07650-C101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)