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General NPI Number Information
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NPI Number | 1033804471
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Entity Type | Individual
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Provider Name | ELLIANA BROOKS MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2010 BRENTWOOD DR
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City | ANDERSON
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State | IN
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Zip | 46011-4042
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Country | US
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Telephone | 765-393-0063
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Fax | 765-393-3761
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Provider Business Mailing Address
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Address Line | 240 N TILLOTSON AVE
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City | MUNCIE
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State | IN
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Zip | 47304-3988
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Country | US
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Telephone | 765-288-1928
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Fax | 765-741-0335
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33011298A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011608A
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License Number State | IN
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