Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brooklyn Lane

Individual provider Mental Health Counselor · NPI 1629833868

Brooklyn Lane is a Mental Health Counselor in Blakely, Georgia. Qualified in 2023, 3 years ago. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2024

Practice location Address checks out

763 Jesse Johnson Dr
Blakely, GA 39823-3224
Phone: (229) 724-2050
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence APC009522 (GA)

Record details

NPI number1629833868
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 16, 2024
Last updated in NPPESFebruary 16, 2024
Certification dateFebruary 16, 2024
Mailing addressPo Box 1988, Albany, GA 31702-1988

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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