Provider Demographics
NPI:1306685029
Name:FOXWORTHY, BROOKE (PHD, LPC-MHSP, QCS)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:FOXWORTHY
Suffix:
Gender:F
Credentials:PHD, LPC-MHSP, QCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13026 LEBANON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2567
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13026 LEBANON RD STE 300
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-2567
Practice Address - Country:US
Practice Address - Phone:615-317-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional