Healthcare Provider Details

I. General information

NPI: 1811456528
Provider Name (Legal Business Name): BROOK S OKASIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 W COLLEGE ST
FLORENCE AL
35630-5313
US

IV. Provider business mailing address

635 W COLLEGE ST
FLORENCE AL
35630-5313
US

V. Phone/Fax

Practice location:
  • Phone: 256-764-3431
  • Fax: 256-765-2036
Mailing address:
  • Phone: 256-764-3431
  • Fax: 256-765-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4649C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: