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NPI Code Detail

MEDICARE: BROOKE DIGIORGIO LCSW

MEDICARE:   BROOKE  DIGIORGIO  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 Worker61976TX

General Provider Information

NPI Number : 1447025101
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE DIGIORGIO LCSW
Provider Business Mailing Address
First Line : 534 TOYAH DR
Second Line :
City : DRIPPING SPRINGS
State : TX
Zip : 78620-2370
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4425 S MOPAC EXPY
Second Line :
City : AUSTIN
State : TX
Zip : 78735-6723
Country : US
Telephone Number : 512-578-8070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2023
Last Update Date : 11/21/2023

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Directions to “ BROOKE DIGIORGIO LCSW” Practice Location

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