Provider Demographics
NPI:1023357332
Name:BROOKS, KRISTEN DANIELLE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DANIELLE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:DANIELLE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 MERCANTILE LN STE 433
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4301
Mailing Address - Country:US
Mailing Address - Phone:240-681-9721
Mailing Address - Fax:240-825-1424
Practice Address - Street 1:1401 MERCANTILE LN STE 433
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4301
Practice Address - Country:US
Practice Address - Phone:240-681-9721
Practice Address - Fax:240-825-1424
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD179771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical