Provider Demographics
NPI:1326510439
Name:BROOKS, SHEMIKA M (PSYD, CGP)
Entity Type:Individual
Prefix:DR
First Name:SHEMIKA
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PSYD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10651 GRAMERCY PL UNIT 258
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3087
Mailing Address - Country:US
Mailing Address - Phone:908-723-0939
Mailing Address - Fax:
Practice Address - Street 1:5116 DORSEY HALL DR STE B
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7877
Practice Address - Country:US
Practice Address - Phone:410-995-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06166103T00000X
103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy