NPI 1306327416 · live from the CMS NPI Registry
Jaclyn Nicole Brooks, MS, LBA, BCBA
Counselor, Mental Health in Lebanon, OR. National Provider Identifier 1306327416, active.
NPI record
| NPI | 1306327416 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 1600 S Main St, Lebanon, OR 97355 |
| Practice phone | 541-915-0787 |
| Mailing address | Po Box 100, Albany, OR 97321 |
| Enumerated | August 27, 2018 |
| Last updated | October 19, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.