Provider Demographics
NPI:1184163693
Name:HAWLEY, BROOKE (LPC, NCC, CADC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:LPC, NCC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2236 E MITCHELL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-9604
Mailing Address - Country:US
Mailing Address - Phone:231-347-9880
Mailing Address - Fax:
Practice Address - Street 1:2236 E MITCHELL RD STE 5
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9604
Practice Address - Country:US
Practice Address - Phone:231-347-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional