Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Kenna Marie Brooks

Peer Specialist β€’ Lacey, WA

Active NPI 1033631668 Individual Practitioner Female Practitioner
Practice location in NPPES

612 Woodland Square Loop Se Ste 401
Lacey, WA 985031070

Call 3609999053 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

612 Woodland Square Loop Se Ste 401

Lacey, WA 985031070

Telephone 3609999053
Organization at the Same NPPES Address or Phone
Thurston Mason Behavioral Health Organization Facility NPI 1265932198

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Olympia, WA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Lacey and Washington

61 active clinicians are listed under Peer Specialist with a practice address in Lacey, WA (2,632 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Lacey

0% of these 61 clinicians have the CMS telehealth indicator.

0% of these 61 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Peer Specialist

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES WA CG60792062

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
1033631668 (WA)
Other Identifier Telecare Mobile Outreach Team
1780913657 (WA)

Secondary Practice Locations

908 5th Ave Se

Olympia, WA 985011507

Phone: 3607542423

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Practice Location March 01, 2019

Registered at 612 WOODLAND SQUARE LOOP SE STE 401, LACEY, WA 985031070 (Tel: 3609999053)

βœ…
NPI Profile Active July 14, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 14, 2017

Registered at 908 5TH AVE SE, OLYMPIA, WA 985011507 (Tel: 3607542423)

πŸ“
Business Mailing Address (Initial Record) July 14, 2017

Registered at 9611 WASHINGTON BLVD SW, LAKEWOOD, WA 984981248 (Tel: 9285035422)

πŸ‘€
Provider Name / Credentials (Initial Record) July 14, 2017

Recorded as KENNA BROOKS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2017

Peer Specialist

🟒
Initial NPI Registration & Enumeration July 14, 2017

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1033631668
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 14, 2017
Last Update: March 01, 2019
Sole Proprietor: No

Mailing Address

9611 Washington Blvd Sw

Lakewood, WA 984981248

Phone: 9285035422

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.