| Jenny Van Overbeke Brooks, Ph.d., P.c. | |
|
4045 Orchard Rd Se Ste 110 Smyrna GA 30080-4904 | |
| (770) 293-1950 | |
| (770) 293-1955 |
| Full Name | Jenny Van Overbeke Brooks, Ph.d., P.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4045 Orchard Rd Se Ste 110, Smyrna, Georgia |
| Authorized Official Name and Position | Jenny Van Overbeke Brooks (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 7702931950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jenny Van Overbeke Brooks, Ph.d., P.c. 4045 Orchard Rd Se Ste 110 Smyrna GA 30080-4904 Ph: (770) 293-1950 | Jenny Van Overbeke Brooks, Ph.d., P.c. 4045 Orchard Rd Se Ste 110 Smyrna GA 30080-4904 Ph: (770) 293-1950 |
| NPI Number | 1407003536 |
|---|---|
| Provider Enumeration Date | 08/20/2008 |
| Last Update Date | 01/29/2020 |
| Certification Date | 01/29/2020 |
| Medicare PECOS PAC ID | 2062577968 |
|---|---|
| Medicare Enrollment ID | O20090210000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407003536 | NPI | - | NPPES |
| 722100907A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY003048 (Georgia) | Primary |
| Provider Name | Jenny V Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598816712 PECOS PAC ID: 8426113325 Enrollment ID: I20090210000036 |
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