MEDICARE: JOEL JACOLE BROOKS

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	171M00000X	Case Manager/Care Coordinator		MA

General Provider Information

NPI Number	:	1366373516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL JACOLE BROOKS

Provider Business Mailing Address
First Line	:	205 WINTHROP ST
Second Line	:
City	:	TAUNTON
State	:	MA
Zip	:	02780-4522
Country	:	US
Telephone Number	:	781-689-3995
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 INDUSTRIAL PARK RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-7246
Country	:	US
Telephone Number	:	781-689-3995
Fax Number	:

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

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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