Healthcare Provider Details

I. General information

NPI: 1316345333
Provider Name (Legal Business Name): BROOKE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 WOODWARD AVE 2ND FLOOR
DETROIT MI
48201-2027
US

IV. Provider business mailing address

32249 TALL TIMBER DR
FARMINGTON HILLS MI
48334-1768
US

V. Phone/Fax

Practice location:
  • Phone: 313-656-4052
  • Fax:
Mailing address:
  • Phone: 248-425-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number6361005687
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6361005687
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6361005687
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: