Organization
BROOK LANE BEHAVIORAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA REPAC (CFO)
(301) 790-9351
Entity
Organization
Contact information
Practice address
13215 BROOK LANE, OUTPATIENT SERVICES, HAGERSTOWN, MD 21742
(301) 733-0330
(240) 310-1927
Mailing address
13121 BROOKLANE DR, HAGERSTOWN, MD 21742-1514
(301) 733-0330
(301) 733-4038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/31/2018
Last updated
01/30/2026
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