Provider Demographics
NPI:1104258631
Name:HADWEN, BROOKE A (LCMHC)
Entity type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:A
Last Name:HADWEN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1620
Mailing Address - Country:US
Mailing Address - Phone:802-324-0791
Mailing Address - Fax:
Practice Address - Street 1:457 NORTH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1620
Practice Address - Country:US
Practice Address - Phone:802-324-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680071602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health