Provider Demographics
NPI:1326360991
Name:BROOKS, DONALD EARL (LSW)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:EARL
Last Name:BROOKS
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 LAKE SHORE BLVD
Mailing Address - Street 2:APT 305
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-1922
Mailing Address - Country:US
Mailing Address - Phone:216-701-9738
Mailing Address - Fax:
Practice Address - Street 1:10000 BRECKSVILLE ROAD
Practice Address - Street 2:US DEPT OF VETERANS AFFAIRS
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141
Practice Address - Country:US
Practice Address - Phone:216-701-9738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0701508104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker