MEDICARE: ANDREA LEWIS-BROOKS CTRS

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	225800000X	Recreation Therapist	84897	IN
2	171M00000X	Case Manager/Care Coordinator
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1730858598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LEWIS-BROOKS CTRS

Provider Business Mailing Address
First Line	:	10755 CYRUS DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1024
Country	:	US
Telephone Number	:	614-296-6776
Fax Number	:

Provider Business Practice Location Address
First Line	:	10755 CYRUS DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1024
Country	:	US
Telephone Number	:	614-296-6776
Fax Number	:

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

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	01/06/2026

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