Provider Demographics
NPI:1083250005
Name:RAWLS, BROOKE NICOLE (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:NICOLE
Last Name:RAWLS
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SHACKELFORD DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2821
Mailing Address - Country:US
Mailing Address - Phone:412-592-2841
Mailing Address - Fax:
Practice Address - Street 1:4108 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2618
Practice Address - Country:US
Practice Address - Phone:412-322-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0205371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical