Brooke Noel Petersen, LPC
Counselor, Professional in Chicago, IL. Individual provider (NPI-1).
NPI number1982108874
StatusActive
Last updated in NPPESMay 11, 2021
Details
- NPI
- 1982108874
- Entity type
- Individual (NPI-1)
- Name
- Brooke Noel Petersen
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2018
- Certification date
- May 11, 2021
- Last updated
- May 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180013512 | IL | Yes |
| 101YP2500X | Counselor, Professional | 178013712 | IL |
Practice location
547 S Clark St Apt 1001Chicago, IL 60605-1547
Phone 630-803-1062
Mailing address
547 S Clark St Apt 1001Chicago, IL 60605-1547
Phone 630-803-1062
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