Healthcare Provider Details

I. General information

NPI: 1558207563
Provider Name (Legal Business Name): BROOKS STROMAN LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 DEERECO RD STE 306
TIMONIUM MD
21093-2152
US

IV. Provider business mailing address

1557 WADSWORTH WAY
BALTIMORE MD
21239-2415
US

V. Phone/Fax

Practice location:
  • Phone: 410-231-3016
  • Fax:
Mailing address:
  • Phone: 410-949-7467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17770
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: