Provider Demographics
NPI:1962144485
Name:HUNTER, BROOKE TENILLE (MS, LCMHCA)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:TENILLE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MS, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 E W T HARRIS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-5123
Mailing Address - Country:US
Mailing Address - Phone:704-405-4265
Mailing Address - Fax:
Practice Address - Street 1:801 CLANTON RD # RC114
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1372
Practice Address - Country:US
Practice Address - Phone:704-840-6088
Practice Address - Fax:800-506-0738
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17496101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)