MEDICARE: SHAMIKA C BROOKS CDCA

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	3747P1801X	Personal Care Attendant
2	376J00000X	Homemaker
3	385H00000X	Respite Care
4	175T00000X	Peer Specialist
5	101YA0400X	Addiction (Substance Use Disorder) Counselor	187411	OH
6	172A00000X	Driver
7	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1457191496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMIKA C BROOKS CDCA

Provider Business Mailing Address
First Line	:	2181 E 70TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4705
Country	:	US
Telephone Number	:	216-213-3138
Fax Number	:

Provider Business Practice Location Address
First Line	:	2181 E 70TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4705
Country	:	US
Telephone Number	:	216-213-3138
Fax Number	:

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

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	01/22/2025

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Directions to “ SHAMIKA C BROOKS CDCA” Practice Location

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