MEDICARE: LATOYA BROOKS-KEY PHD, MSW, MA, 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	C011223	NC
2	1041C0700X	Clinical Social Worker	CW016108	PA
3	1041C0700X	Clinical Social Worker	SW13225CP	SC

General Provider Information

NPI Number	:	1861642266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA BROOKS-KEY PHD, MSW, MA, LCSW,

Provider Business Mailing Address
First Line	:	9600 TWO NOTCH RD STE 5
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-1612
Country	:	US
Telephone Number	:	803-939-6680
Fax Number	:

Provider Business Practice Location Address
First Line	:	9600 TWO NOTCH RD STE 5
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-1612
Country	:	US
Telephone Number	:	803-939-6680
Fax Number	:

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

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	09/17/2024

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