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Individual
WALTER BROOKS
Active
Individual
WALTER BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003956
GA
103TC1900X
Counseling Psychologist
1091587
GA
103TH0100X
Health Service Psychologist
LPC003956
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033128490
DRIVERS LICENSE
GA
01
—
1091587
PHD HUMAN SERVICES PROFESSIONAL COUNSELING SPECIALIZATION
GA
01
—
LPC003956
LICENSE PROFESSIONAL COUNSELING
GA
Enumeration date
02/22/2012
Last updated
05/29/2023
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