Healthcare Provider Details

I. General information

NPI: 1922479757
Provider Name (Legal Business Name): ELIZABETH BROOKS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH SMITH

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GOODMAN ST S STE 323
ROCHESTER NY
14620-2530
US

IV. Provider business mailing address

34 BROOK HILL LN APT B
ROCHESTER NY
14625-2248
US

V. Phone/Fax

Practice location:
  • Phone: 315-961-9715
  • Fax:
Mailing address:
  • Phone: 315-961-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number095770
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: