Provider Demographics
NPI:1427764992
Name:BROOKES, JOY (CHT, ORDM)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:BROOKES
Suffix:
Gender:F
Credentials:CHT, ORDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 SOUTH AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-2255
Mailing Address - Country:US
Mailing Address - Phone:866-869-5692
Mailing Address - Fax:
Practice Address - Street 1:313 SOUTH AVE STE 406
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-2255
Practice Address - Country:US
Practice Address - Phone:417-693-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA404577174400000X
AZ101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty