MEDICARE: LAURA R, BROOKS MSW

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
1	1041C0700X	Clinical Social Worker	05454	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255354353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA R, BROOKS MSW

Provider Business Mailing Address
First Line	:	3355 SAINT JOHNS LN # 3
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2605
Country	:	US
Telephone Number	:	443-956-7282
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 SAINT JOHNS LN # 3
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2605
Country	:	US
Telephone Number	:	443-956-7282
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/20/2021

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Directions to “ LAURA R, BROOKS MSW” Practice Location

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