Provider Demographics
NPI:1528641073
Name:KEELS, BROOKE OWENS (PHD, LPC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:OWENS
Last Name:KEELS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15328 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6210
Mailing Address - Country:US
Mailing Address - Phone:615-831-6987
Mailing Address - Fax:
Practice Address - Street 1:5344 ALPHA RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-3428
Practice Address - Country:US
Practice Address - Phone:817-966-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4298101YP2500X
TN4130101YP2500X
TX85982101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional