Provider Demographics
NPI:1144745779
Name:JOHNSON-HINTZ, BROOKE (LPC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:JOHNSON-HINTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 S BARSTOW ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-3642
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:N36647 COUNTY ROAD QQQ
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:WI
Practice Address - Zip Code:54773-4400
Practice Address - Country:US
Practice Address - Phone:715-538-9134
Practice Address - Fax:715-538-9131
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3556-226101YP2500X
WI7382-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional