Provider Demographics
NPI:1275845182
Name:BROOKES, JAMES DAVID (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:BROOKES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 BLUE SKY DR
Mailing Address - Street 2:
Mailing Address - City:CONNELLYS SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28612-7496
Mailing Address - Country:US
Mailing Address - Phone:828-439-7862
Mailing Address - Fax:
Practice Address - Street 1:1013 WEST AVE NW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5126
Practice Address - Country:US
Practice Address - Phone:828-572-1636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC001896OtherLCSW LICENSE NUMBER