Provider Demographics
NPI:1306661301
Name:PATE, BROOKE (LPC-MHSP, NCC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:PATE
Suffix:
Gender:F
Credentials:LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2273 MAYTOWN CIR
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-1013
Mailing Address - Country:US
Mailing Address - Phone:615-830-9221
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 405
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1104
Practice Address - Country:US
Practice Address - Phone:615-830-9221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5963101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health