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NPI Code Detail

MEDICARE: MS. SUSAN WHITMORE BROOKS MSSW, LCSW

MEDICARE: MS. SUSAN WHITMORE BROOKS MSSW, LCSW
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
11041C0700XClinical Social Worker1458123WI
2104100000XSocial WorkerC006398NC
31041C0700XClinical Social Worker

Other Identifiers

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

General Provider Information

NPI Number : 1386659704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN WHITMORE BROOKS MSSW, LCSW
Provider Business Mailing Address
First Line : 2024 NEW HOPE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6064
Country : US
Telephone Number : 608-692-6066
Fax Number : 608-275-5546
Provider Business Practice Location Address
First Line : 2024 NEW HOPE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6064
Country : US
Telephone Number : 608-692-6066
Fax Number : 608-275-5546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 08/28/2013

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