Provider Demographics
NPI:1598098311
Name:BROOKS, TENESHA (MSW, LICSW, LCSW)
Entity Type:Individual
Prefix:
First Name:TENESHA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:TENESHA
Other - Middle Name:PATRICIA
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:61 N PLAINS INDUSTRIAL RD # 188
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5841
Mailing Address - Country:US
Mailing Address - Phone:203-491-0650
Mailing Address - Fax:
Practice Address - Street 1:111 SOUTH ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4297
Practice Address - Country:US
Practice Address - Phone:617-284-5130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker