KYSHIA BROOKS LCAS/OWNER - NPI 1043554454

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

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About Kyshia Brooks Lcas/owner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYSHIA BROOKS LCAS/OWNER (NPI 1043554454) is an individual mental health provider in Tucker, Georgia, licensed in North Carolina (2499-A) and active in the NPI registry since November 2012.

NPPES Registry Identity

NPI1043554454

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKYSHIA BROOKSCredential: LCAS/OWNER

Location Address4500 HUGH HOWELL RD STE 430Tucker, GA 30084-4722

Mailing Address4500 Hugh Howell Rd Ste 430Tucker, GA 30084-4722 · (470) 668-9295

Phone(470) 668-9295

Sole ProprietorYes

Enumeration DateNovember 26, 2012

Last NPPES UpdateJuly 23, 2021

NPPES CertifiedJuly 23, 2021

✔ NPI 1043554454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in NC · 2499-A

4500 HUGH HOWELL RD STE 430, Tucker, GA 30084

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Other Identifiers 1

Medicaid6008513NC

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COBY LABORATORIES & SCREENING, LLC

Technician, Pathology (Medical Laboratory)