MEDICARE: DANIEL L BROOKS 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
1	1041C0700X	Clinical Social Worker	0904012539	VA

General Provider Information

NPI Number	:	1538589692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL L BROOKS LCSW

Provider Business Mailing Address
First Line	:	4866 OLD MOUNTAIN RD NE
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24019-5454
Country	:	US
Telephone Number	:	540-238-6948
Fax Number	:

Provider Business Practice Location Address
First Line	:	4866 OLD MOUNTAIN RD NE
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24019-5454
Country	:	US
Telephone Number	:	540-238-6948
Fax Number	:

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

Provider Enumeration Date	:	04/16/2014
Last Update Date	:	01/29/2026

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