1992116057 NPI number — MS. BROOKE L STRANGE LBS, EDS, MFT, NCC

Table of content: MS. BROOKE L STRANGE LBS, EDS, MFT, NCC (NPI 1992116057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992116057 NPI number — MS. BROOKE L STRANGE LBS, EDS, MFT, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRANGE
Provider First Name:
BROOKE
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LBS, EDS, MFT, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STRANGE
Provider Other First Name:
BROOKIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LBS, EDS, MFT, NCC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1992116057
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 MINERAL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19464-4043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-247-1166
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
390 WATERLOO BLVD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
EXTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19341-2603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-363-5500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  BH001361 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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