Provider Demographics
NPI:1790591436
Name:BROOKS, CHRISTINA LOUISE (LPC-A)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 S 4TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-1524
Mailing Address - Country:US
Mailing Address - Phone:806-781-8484
Mailing Address - Fax:
Practice Address - Street 1:1605 S 4TH ST APT 105
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-1524
Practice Address - Country:US
Practice Address - Phone:806-781-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97247101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional