Provider Demographics
NPI:1285473892
Name:BROOKS, JANELLE H (PHD)
Entity type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:H
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 DOGWOOD PASS
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3368
Mailing Address - Country:US
Mailing Address - Phone:706-589-0211
Mailing Address - Fax:
Practice Address - Street 1:2055 GEES MILL RD NE STE 315
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1364
Practice Address - Country:US
Practice Address - Phone:470-296-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional