Provider Demographics
NPI:1063634798
Name:BROOKS, JUNE MARIE (GSW)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:MARIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3553
Mailing Address - Country:US
Mailing Address - Phone:504-896-2345
Mailing Address - Fax:504-896-2240
Practice Address - Street 1:1538 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3553
Practice Address - Country:US
Practice Address - Phone:504-896-2345
Practice Address - Fax:504-896-2240
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5730104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker