BROOKE DIETZ (NPI# 1124496187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124496187 |
| Entity Type | Individual |
| Full Name | BROOKE DIETZ |
| Practice Address |
2025 Bypass Rd Suite 205 Brandenburg KY 40108-1605 |
| Mailing Address |
2607 Shining Water Dr Apt 104 Louisville KY 40299-6958 |
| Practice Telephone | 2704223971 |
| Mailing Telephone | 7348832814 |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
2025 BYPASS RD SUITE 205 |
| City | BRANDENBURG |
| State | KY |
| Zip Code | 40108-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265763544 | Sandy M Hampton | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2010-01-26 |
| 1033610225 | Latasha Youngblood | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2018-02-23 |
| 1164944963 | Candy Renea Rogers | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2017-07-13 |
| 1255883559 | Terri Dykhuis | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2016-11-02 |
| 1861813214 | Angela O'donoghue | Social Worker | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2014-01-02 |
| 1194153031 | Courtney Lynn Campbell | Social Worker | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2013-10-30 |
| 1417209461 | Pamela Jean Veach | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1631 | 2012-10-15 |
| 1699040147 | Zoe Renee Leibowitz | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1631 | 2012-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316468036 | Elisabeth Shoulders | Specialist/Technologist | 1010 Turner Road, Brandenburg, KY 40108 | 2017-07-03 |
| 1760890958 | Kimberly Ryan | Social Worker | 2020 Bypass Rd, Brandenburg, KY 40108 | 2014-07-31 |
| 1962790600 | Meade Family Eye, Pllc | Optometrist | 664 By Pass Rd, Brandenburg, KY 40108 | 2011-07-15 |
| 1295066934 | Raymond Lewis Mathis | Family Medicine | 65 Cedar Vista Dr, Brandenburg, KY 40108 | 2010-01-20 |
| 1790951804 | Elizabeth Mary Wright | Physical Therapist | 1155 Old Ekron Rd, Brandenburg, KY 40108 | 2008-05-08 |
| 1427240704 | Bluegrass Massage Theraputics | Clinic/Center | 365 East Broadway Suite 2, Brandenburg, KY 40108 | 2007-08-10 |
| 1710969316 | Lincoln Trail District Health Dept | Public Health or Welfare | 520 Hillcrest Dr, Brandenburg, KY 40108 | 2005-11-18 |
| 1437676475 | Ack Healthcare Management, LLC | Nurse Practitioner | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108 | 2017-08-29 |
| 1598135055 | Forefront Dermatology, S.c. | Dermatology | 100 Commerce Dr, C/o Brandenburg Diagnostic Center, Brandenburg, KY 40108 | 2015-09-28 |
| 1457479396 | Robert Eugene Smith | Family Medicine | 534 Hillcrest Drive, Brandenburg, KY 40108 | 2007-03-27 |
| Find all providers in zip 40108 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265763544 | Sandy M Hampton | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2010-01-26 |
| 1164944963 | Candy Renea Rogers | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2017-07-13 |
| 1255883559 | Terri Dykhuis | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1605 | 2016-11-02 |
| 1932533791 | Shelby Dakota Sloan | Counselor | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108-1605 | 2013-08-29 |
| 1144654906 | Trisha Daniele Bender | Counselor | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108-1605 | 2013-08-29 |
| 1124452917 | Brianna Donn Hardy | Counselor | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108-1605 | 2013-08-28 |
| 1417209461 | Pamela Jean Veach | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1631 | 2012-10-15 |
| 1134483795 | Quatavia Shertonia Wilkins | Counselor | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108-1634 | 2012-06-28 |
| 1699040147 | Zoe Renee Leibowitz | Counselor | 2025 Bypass Rd, Brandenburg, KY 40108-1631 | 2012-03-16 |
| 1306128319 | Felicia L Schultz | Counselor | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108-1634 | 2011-09-15 |
| Find all providers in BRANDENBURG | ||||
| City | BRANDENBURG |
| Zip Code | 40108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.