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General NPI Number Information
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NPI Number | 1144909615
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Entity Type | Individual
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Provider Name | AMELIA BROOKS LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 440 Monticello Ave Ste 1802
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City | Norfolk
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State | VA
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Zip | 2310-2670
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Country | US
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Telephone | 804-715-5371
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Fax | 855-716-7553
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Provider Business Mailing Address
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Address Line | 440 Monticello Ave Ste 1802
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City | Norfolk
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State | VA
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Zip | 23510-2670
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Country | US
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Telephone | 804-715-5371
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Fax | 855-716-7553
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904015308
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License Number State | VA
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