Provider Demographics
NPI:1477583185
Name:DETTE, BROOKE JANINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:JANINE
Last Name:DETTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LINCOLN RD # 1508
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2013
Mailing Address - Country:US
Mailing Address - Phone:917-415-0168
Mailing Address - Fax:
Practice Address - Street 1:5200 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-2706
Practice Address - Country:US
Practice Address - Phone:305-514-8524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 82511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical