Provider Demographics
NPI:1447423306
Name:BROOKS, ANNE L (DSW,LCSW)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:L
Last Name:BROOKS
Suffix:
Gender:F
Credentials:DSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 BANK ST
Mailing Address - Street 2:301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2183
Mailing Address - Country:US
Mailing Address - Phone:212-675-5881
Mailing Address - Fax:212-675-5881
Practice Address - Street 1:69 BANK ST
Practice Address - Street 2:301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2183
Practice Address - Country:US
Practice Address - Phone:212-675-5881
Practice Address - Fax:212-675-5881
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR190351041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNOO201Medicare PIN