Individual
TYNESHIA A BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CPCI
Contact information
Practice address
913 CRESCENT FALLS ST, HENDERSON, NV 89011-2516
(702) 498-1743
Mailing address
PO BOX 92168, HENDERSON, NV 89009-2168
(702) 498-1743
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CP0280
NV
101YP2500X
Professional Counselor
CP0280
NV
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
CP0280
NV
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427386267
—
NV
Enumeration date
07/05/2012
Last updated
07/13/2018
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