Provider Demographics
NPI:1366559007
Name:LEE, BROOKE DENISE (LPC, CAC III, MED)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:DENISE
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC, CAC III, MED
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:DENISE
Other - Last Name:DELEHOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:226 MT HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERANCE
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4870
Mailing Address - Country:US
Mailing Address - Phone:970-460-8494
Mailing Address - Fax:
Practice Address - Street 1:226 MT HARVARD AVE
Practice Address - Street 2:
Practice Address - City:SEVERANCE
Practice Address - State:CO
Practice Address - Zip Code:80550-4870
Practice Address - Country:US
Practice Address - Phone:970-460-8494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0007031101YA0400X
COLPC.0005090101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)