Provider Demographics
NPI:1003067653
Name:BROWN, BROOKE M (LGSW)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:MS
Other - First Name:BROOKE
Other - Middle Name:ELIZABETH
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2013 HIDDEN FOREST LN
Mailing Address - Street 2:
Mailing Address - City:MONTEVALLO
Mailing Address - State:AL
Mailing Address - Zip Code:35115-5925
Mailing Address - Country:US
Mailing Address - Phone:205-902-6088
Mailing Address - Fax:
Practice Address - Street 1:987 HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:AL
Practice Address - Zip Code:35051
Practice Address - Country:US
Practice Address - Phone:205-669-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2311G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker