Provider Demographics
NPI:1760602536
Name:BROOKS, ABIGAIL AILEEN (LICSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:AILEEN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:AILEEN
Other - Middle Name:FRANCES
Other - Last Name:OCKWIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:17057 EAGLEVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-7304
Mailing Address - Country:US
Mailing Address - Phone:612-913-6590
Mailing Address - Fax:507-206-2573
Practice Address - Street 1:251 WOOD LAKE SE
Practice Address - Street 2:ROCHESTER COMMUNITY BEHAVIORAL HEALTH HOSPITAL
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904
Practice Address - Country:US
Practice Address - Phone:952-206-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical