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NPI Code Detail

MEDICARE: BROOKE NICOLE GENERETT L.C.S.W.

MEDICARE: BROOKE NICOLE GENERETT L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerSW125755PA
21041C0700XClinical Social WorkerCW017069PA

General Provider Information

NPI Number : 1184890998
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE NICOLE GENERETT L.C.S.W.
Provider Business Mailing Address
First Line : 5655 BRYANT ST
Second Line : THE NUIN CENTER
City : PITTSBURGH
State : PA
Zip : 15206-1511
Country : US
Telephone Number : 412-805-5273
Fax Number :
Provider Business Practice Location Address
First Line : 5655 BRYANT ST
Second Line : THE NUIN CENTER
City : PITTSBURGH
State : PA
Zip : 15206-1511
Country : US
Telephone Number : 412-805-5273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2008
Last Update Date : 03/17/2013

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Directions to “ BROOKE NICOLE GENERETT L.C.S.W.” Practice Location

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