Basic Information
| Provider Information | |||||||||
| NPI: | 1164672291 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROOKS | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BULLHARD | ||||||||
| OtherFirstName: | LINDSEY | ||||||||
| OtherMiddleName: | ANN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 299 | ||||||||
| Address2: | 503 SE LINDSEY | ||||||||
| City: | HOXIE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708861333 | ||||||||
| FaxNumber: | 8708861334 | ||||||||
| Practice Location | |||||||||
| Address1: | 503 SE LINDSEY | ||||||||
| Address2: | |||||||||
| City: | HOXIE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708861333 | ||||||||
| FaxNumber: | 8708861334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2008 | ||||||||
| LastUpdateDate: | 03/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101Y00000X | P1608111 | AR | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.