# BROOKE OSTERHOUDT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BROOKE OSTERHOUDT, PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679182984
- **Legal business name:** BROOKE OSTERHOUDT, PLLC
- **Authorized official:** SHANA LOTT (PRACTICE MANAGER)
- **Authorized official phone:** (303) 408-4455

## Contact information

- **Practice address:** 4341 CHARLOTTE HWY STE 202, LAKE WYLIE, SC 29710-7062
- **Practice address phone:** (303) 408-4455
- **Mailing address:** 16 HAMILTONS FERRY RD, CLOVER, SC 29710-8911
- **Mailing address phone:** (303) 408-4455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/23/2020
- **Last updated:** 07/23/2020