Provider Demographics
NPI:1053600551
Name:BROOKS, LYNN B (MS ED D)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:B
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MS ED D
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:BUIE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS ED D
Mailing Address - Street 1:460 SANDYBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-2923
Mailing Address - Country:US
Mailing Address - Phone:404-552-4284
Mailing Address - Fax:336-886-0142
Practice Address - Street 1:460 SANDYBROOKE DR.
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265
Practice Address - Country:US
Practice Address - Phone:404-552-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8620494101YP2500X
GA8620494101YP2500X, 171M00000X
MN40918375101YP2500X, 171M00000X
NC8620494171M00000X
NCA8001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA8620494OtherHEALTHCARE MARKETPLACE NPN
MN40918375OtherACCIDENT & HEALTH, LIFE
NC8620494OtherLICENSE ACCIDENT & SICKNESS, LIFE, LONG-TERM CARE
SC8620494OtherACCIDENT, HEALTH OR SICKNESS, LIFE